Nature Metabolism, Published online: 03 June 2026; doi:10.1038/s42255-026-01552-6The recent global consensus to rename polycystic ovary syndrome (PCOS) as polyendocrine metabolic ovarian syndrome (PMOS) accurately reframes the condition as a lifelong, multisystemic disorder rather than a localized ovarian pathology. This transition underscores the central role of metabolic dysfunction, specifically the high prevalence of insulin resistance and hyperinsulinaemia, and has important consequences for basic and clinical research.