Renewable Energy Sources are becoming widely spread, as they are sustainable and low-carbon emission. They are mostly penetrating the MV Distribution Networks as Distributed Generators, which has determined the evolution of the networks’ control and supervision systems, from almost a complete lack to becoming fully centralized. This paper proposes innovative voltage control architectures for the distribution networks, tailored for different development levels of the control and supervision systems encountered in real life: a Coordinated Control for networks with basic development, and an optimization-based Centralized Control for networks with fully articulated systems. The Centralized Control fits the requirements of the network: the challenging harmonization of the generator’s capability curves with the regulatory framework, and modelling of the discrete control of the On-Load Tap Changer transformer. A realistic network is used for tests and comparisons with the Local Strategy currently specified by regulations. The proposed Coordinated Control gives much better results with respect to the Local Strategy, in terms of loss minimization and voltage violations mitigation, and can be used for networks with poorly developed supervision and control systems, while Centralized Control proves the best solution, but can be applied only in fully supervised and controlled networks.