Reduced oocyte quality, mainly due to mitochondrial dysfunction, is a key cause of subfertility in patients with metabolic diseases such as obesity. Recent fundamental understanding of the underlying mechanisms highlights the importance of developing effective preconception care strategies not only to improve metabolic health, but also oocyte quality. Minimizing mitochondrial oxidative stress either in vivo or in vitro is a promising solution, however further investigations should consider the long-term consequences on epigenetic programming and offspring health.