Polycystic ovary syndrome (PCOS) is a common heterogeneous endocrine disorder in women of reproductive age, characterized by gynecological problems such as altered menstrual cycles and infertility, as well as metabolic and psychological manifestations. Many pathophysiological processes, including insulin resistance, have been implicated in its development, and the modern human diet is considered a key inciting factor. A low-carbohydrate diet (LCD) holds great promise in its management. A scoping review was conducted to find the range of carbohydrate restriction and macronutrient composition in LCDs used by various authors globally and their effects on multiple features of the syndrome. Using Medical Subject Headings (MeSH) terms and keywords, a literature search was performed in PubMed, EMBASE, Webof Science, and Cochrane. Original research papers published in English were screened, and 2 independent researchers extracted data. The quantity of carbohydrates ranged from 5% to 44% of total energy derived from diet or 16 g to 100 g; fat ranged from 30% to 75% or 40-134 g; protein intake ranged from 18% to 30% or 90 g or 1.1 to 1.2 g/kg of body weight. Lowering carbohydrate content has caused favorable changes in body mass index, waist circumference, and various metabolic and hormonal indices. The quantum of macronutrients employed varied widely in studies on LCDs for PCOS. While various benefits occur with the diet intervention, unfavorable increases in low-density lipoprotein, triglycerides, and blood pressure are noted with very low-carbohydrate, high-protein diet formulations. There is a need to formulate a standardized LCD and study its effects on PCOS in the long term. © 2025 Elsevier B.V., All rights reserved.