There are over 1014 organisms in the human gut microbiome with the majority being bacteria, and such a diverse system is very beneficial and harmful in equal measure. This previously undigested material is fermented to provide energy in the form of short chain fatty acids that also nourish the mucosal gut lining. The microbiome is also impacted by various factors, which include diet, age, individual genetic background and environmental exposures. As a result of high microbial diversity being absent, dysbiosis has been associated with numerous metabolic diseases including obesity and diabetes. Probiotics and prebiotics are examples of products that work at restoring the microbial ecosystem to prevent metabolic dysfunction. Faecal microbiota transplantation (FMT) has shown good results in dealing with diseases related to dysbiosis. Treatment outcomes are diverse, particularly due to the gut microbiota-drug interactions, hence there is need for individualised therapy. Internal medicine focuses on non-pharmacological means of ensuring the health of the gut including changes in behaviour and diet. Due to ongoing studies linking microbiome and microbe energetic spent cabinet health, these developments create opportunities for new methods of treatment in consideration of the escalating cases of metabolic diseases across all regions.