Fructose consumption has dramatically increased worldwide over the past decades. There are numerous clinical, experimental, and epidemiological studies evidenced that increased consumption of fructose negatively impacts carbohydrate metabolism and lactate formed from fructose can also affect whole-body energy balance. Excessive fructose intake stimulates endogenous glucose production and lipid synthesis in the liver. Currently fructose is believed to be a major contributing factor to chronic metabolic diseases, including obesity, insulin resistance, hypertriglyceridemia, and non-alcoholic fatty liver disease, hyperglycemia, type 2 diabetes, and cancer. These new findings bring challenges to researchers today because of what is still to be discovered, and how to apply what has been discovered to modern health. Further investigation should seek to analyze and understand specific mechanistic effects of fructose in metabolic pathways, and how to apply this knowledge to our daily lives. Conducting this monosaccharide research is important to improve the diet of the general population and to attenuate the epidemics of metabolic disease and associated diseases. Here, we focus on the mechanism and role of fructose in diseases as well as its potential as a dietary interventional target.