This narrative review explores the correlation between insulin resistance (IR) and infertility, highlighting its impact on female reproductive function and the risk of infertility. IR is linked to various metabolic diseases and affects oocyte development, embryo quality, endometrial tolerance, and hormone secretion, ultimately influencing assisted reproductive technology outcomes. IR is also associated with spontaneous abortion, gestational diabetes, and adverse pregnancy outcomes, which can have long-term effects on offspring health. The review discusses the mechanisms by which IR exacerbates hyperandrogenism, impairs endometrial tolerance, and increases oxidative stress and inflammation. It also examines the effectiveness of treatments for IR in polycystic ovary syndrome (PCOS) and non-PCOS infertility, including lifestyle interventions, metformin, and targeted therapies. Additionally, the review highlights the impact of IR on pregnancy complications such as recurrent miscarriage, gestational diabetes, and hypertension, as well as neonatal and postpartum outcomes. The authors emphasize the need for further research to understand the complex mechanisms involved and to develop effective management strategies for IR-related infertility.This narrative review explores the correlation between insulin resistance (IR) and infertility, highlighting its impact on female reproductive function and the risk of infertility. IR is linked to various metabolic diseases and affects oocyte development, embryo quality, endometrial tolerance, and hormone secretion, ultimately influencing assisted reproductive technology outcomes. IR is also associated with spontaneous abortion, gestational diabetes, and adverse pregnancy outcomes, which can have long-term effects on offspring health. The review discusses the mechanisms by which IR exacerbates hyperandrogenism, impairs endometrial tolerance, and increases oxidative stress and inflammation. It also examines the effectiveness of treatments for IR in polycystic ovary syndrome (PCOS) and non-PCOS infertility, including lifestyle interventions, metformin, and targeted therapies. Additionally, the review highlights the impact of IR on pregnancy complications such as recurrent miscarriage, gestational diabetes, and hypertension, as well as neonatal and postpartum outcomes. The authors emphasize the need for further research to understand the complex mechanisms involved and to develop effective management strategies for IR-related infertility.