Obesity in women of reproductive age is associated with metabolic dysfunction and adverse reproductive outcomes, particularly when coexisting with polyendocrine metabolic ovarian syndrome. Glucagon-like peptide-1 receptor agonists have emerged as effective pharmacological treatments for obesity; however, their clinical relevance in reproductive-age women may extend beyond weight reduction. This review aimed to evaluate the effects of glucagon-like peptide-1 receptor agonists on nutritional status, metabolic health, and reproductive outcomes in women with obesity, with particular attention to those with polyendocrine metabolic ovarian syndrome. Randomized controlled trials published between 2008 and 2025 were identified, and studies evaluating glucagon-like peptide-1 receptor agonists in women with overweight or obesity were included. Twelve randomized controlled trials were included, evaluating exenatide, liraglutide, dulaglutide, beinaglutide, and semaglutide, with comparators including metformin, placebo, caloric restriction, or pharmacological strategies. Due to substantial heterogeneity in interventions, doses, treatment duration, populations, and outcomes, findings were synthesized narratively rather than pooled quantitatively. Across studies, glucagon-like peptide-1 receptor agonists consistently reduced body weight, body mass index, and waist circumference, while improvements in glycemic control, insulin sensitivity, and selected hormonal parameters were also reported. Liraglutide was associated with reductions in visceral and hepatic fat, whereas exenatide, alone or combined with metformin, improved sustained prediabetes remission and menstrual outcomes. Reproductive findings were promising but heterogeneous, including increased spontaneous pregnancy and improved pregnancy rates following assisted reproduction in selected studies; however, some differences were not maintained during longer follow-up, and evidence for improved pregnancy outcomes remained limited. A recent trial with semaglutide also demonstrated changes in taste perception and neural responses to food stimuli, suggesting effects on mechanisms involved in eating behavior. In contrast, direct assessments of dietary intake, diet quality, nutrient adequacy, and overall nutritional status were scarce, representing an important gap in the evidence. These findings indicate that therapeutic response should not be evaluated solely by kilograms lost. Weight reduction may occur alongside improvements in metabolic and reproductive parameters, but these outcomes are distinct and cannot be assumed to result exclusively from weight loss. For women of reproductive age, particularly those with polyendocrine metabolic ovarian syndrome, treatment assessment should incorporate body composition, metabolic health, nutritional adequacy, and reproductive outcomes, especially during preconception care. Further randomized controlled trials should prospectively evaluate dietary quality, nutrient intake, body composition, and reproductive outcomes alongside weight loss to determine whether glucagon-like peptide-1 receptor agonist therapy provides clinically meaningful benefits beyond weight reduction.