Metabolic diseases are considered the primary culprit for physical and mental health of individuals. Although the diagnosis of these diseases is relatively easy, more effective and convenient potent drugs are still being explored. Ca 2+ across the inner mitochondrial membrane is a vital intracellular messenger that regulates energy metabolism and cellular Ca 2+ homeostasis and is involved in cell death. Mitochondria rely on a selective mitochondrial Ca 2+ unidirectional transport complex (MCU complex) in their inner membrane for Ca 2+ uptake. We found that the channel contains several subunits and undergoes dramatic transformations in various pathological processes, especially in metabolic diseases. In this way, we believe that the MCU complex becomes a target with significant potential for these diseases. However, there is no review linking the two factors, thus hindering the possibility of new drug production. Here, we highlight the connection between MCU complex-related Ca 2+ transport and the pathophysiology of metabolic diseases, adding understanding and insight at the molecular level to provide new insights for targeting MCU to reverse metabolism-related diseases.