This narrative review aims to understand the pathophysiology of PCOS and compare the role of metformin with that of new emerging therapies, including sodium-glucose cotransporter-2 (SGLT-2) inhibitors, oral contraceptive pills (OCPs), inositol supplements, and lifestyle modifications, thereby empowering clinicians to provide personalized medicine based on each patient’s unique presentation. This evidence concerns the gene SLC5A2 and polycystic ovary syndrome.