Patient preferences for treatment characteristics—such as dosage form, taste, smell, and ingredients—play a key role in adherence, yet these preferences differ widely across cultures and are frequently overlooked in pharmaceutical development. Prescription medicines must meet strict safety and effectiveness standards, restricting flexibility, whereas over-the-counter supplements allow more freedom, though often without proven benefits. Developing diverse formulations is expensive and time-consuming, and patients need clear guidance to make informed choices without feeling overwhelmed or questioning their doctors. This tension highlights a disconnect between patient desires, scientific validation, and practical feasibility. We urge healthcare providers, pharmaceutical companies, and patients to engage in dialogue to discuss patient preferences and diversity in drug development. By creating treatments that reflect cultural needs and improving patient education, adherence and equity in healthcare can improve, provided the scientific, economic, and logistical hurdles are addressed effectively.