One of the symptoms of PCOS is insulin resistance and metformin is one of the best treatments for that. PCOS is a complex endocrin condition and metformin is by no means a cure, but restoring a more normal state to glucose metabolism through diet and metformin can reduce other symptoms and for some help to restore their fertility.
Insulin resistance is also feature of T2 diabetes. Metformin helps your body to use the insulin it can still produce by reducing insulin resistance which reduces the stress on your pancreas. Eventually your body loses the ability to produce enough insulin, that happens faster if the insulin resistance isn't treated. When you reach the point where your body can't produced enough insulin eventually even metformin will stop being effective. That's when the medications that increase insulin production or insulin injection become necessary. Interestingly, T1 diabetics can also become insulin resistant.
Studies have shown that starting metformin in the insulin resistance phase of T2 can effectively buy time. It slows the progression of T2 and can delay the onset of the next phase of the disease and subsequent complications for up to ten years. IMHO that makes metformin worth taking and why I've been taking it for the last eight years. I'm buying myself time, and based on my family history, it's working. I am in a better state of health than any of my T2 relatives were at the same age.
That wouldn't be the case for me if I had shunned medication or hadn't asked for an appropriate level of care from my GP.
Metformin can cause B12 deficiency, but that's easily treatable. It needs to be started early and used consistently to be most effective. And it is likely that everyone who uses on metformin will eventually require other medications in conjunction or insulin at the later stages. What I do know from observing the lives of diabetic family members and from being T2 myself is that the earlier you make sensible lifestyle changes and make use of appropriate treatments, the better your outcome will be.
Diabetes is a disease where forward planning is necessary, whether it's making the choice to take medication to try to change an outcome that's perhaps 10, 20, or 30 years in the future or planning your lunch for the day to prevent a high or a hypo.