Precision medicine is a transformative approach to health care that addresses the inherent variability among individuals in terms of genetics, environment and lifestyle. It involves the customization of medical care to the unique characteristics of each individual, with the aim of optimizing treatment efficacy and minimizing adverse effects. This paradigm shift is made possible by the integration of comprehensive data, including multi-omics and clinical information, which allows for a more nuanced understanding of pathophysiological mechanisms and individual responses to interventions. One of them, also considered as medicine, is exercise. In the realm of exercise programmes for the prevention and treatment of a range of acute and chronic conditions, precision exercise prescription becomes particularly crucial. The variable nature of individual responses to exercise requires a tailored approach to maximize the benefits for each person, while reducing the risks of injury. Within the context of metabolic syndrome (MetS) acting as a crucial factor in the ongoing global cardiovascular crisis, and knowing the key role of exercise in the development and progression of MetS, the capability to forecast individual responses facilitates the development of personalized exercise strategies designed to address an individual's distinct risk profile.