This review discusses the current and next steps in research of algorithms for dynamical fermions in large scale lattice QCD simulations. First a short overview on the state-of-the-art of ensemble generation at the physical point is given. Followed by an overview on required steps towards simulation of large lattices for the Hybrid Monte Carlo algorithm. Here, in particular, the status of iterative solvers and tuning procedures for numerical integrators within the molecular dynamics are discussed. This is followed by a review on the on-going developments for algorithms, with a focus on methods which are potentially useful to simulate gauge theories at very fine lattice spacings, i.e. well suited to overcome freezing of the topological charge. This includes modification of the HMC algorithm as well as a discussion of algorithms which includes the fermion weight via global correction steps. Parts of the discussions are on the application of generative models via gauge equivariant flows as well as multi-level algorithms.