Marty Makary resigned as FDA commissioner, ending a contentious tenure that included frequent leadership turnover and shifting guidance dynamics for regulated companies. President Trump confirmed the change, and Kyle Diamantas, previously deputy commissioner for food, is set to serve as acting commissioner. Analysts cited uncertainty in predictability around FDA review and guidance. During his time in the role, Makary also advanced policies intended to speed drug development, including new voucher concepts, ultra-rare disease approval frameworks, and AI use in review processes—while critics pointed to operational disruptions and delayed reviews.