Therefore, we propose a model focusing on ta-VNS that can act on multiple pathways that may treat PCOS (as shown in Table 1 and Fig. 2), including (1) regulating energy metabolism via bidirectional vagal signaling; (2) reversing IR via its antidiabetic effects; (3) activating anti-inflammatory responses through the HPAA, ChAP, and SSAP; (4) restoring homeostasis of the microbiota-gut-brain axis; (5) restoring the sympatho-vagal balance to improve CVD outcomes; and (6) modulating mental disorders. Here, SYNPO2L is linked to psychiatric disorder.