Abstract: The prevalence of metabolic syndrome (MetS) continues to rise, posing a serious threat to human health. This paper interprets the Inner Classic concept of “spleen storing nutrients” as the central regulatory hub for metabolic homeostasis and deconstructs the function of “spleen governing transportation and transformation” into a dynamic model comprising eight key links and four major stages. It proposes that “dysfunction of the spleen-stomach qi transformation pivot” is the initiating cause of MetS; that impaired spleen nutrient transportation and transformation, along with disordered distribution of nutrient essences, constitute the core pathogenesis; and that the endogenous generation of phlegm-dampness, stasis, and turbidity, followed by the deposition of adipose-phlegm-turbidity, represents the pathological outcome. The progression of MetS unfolds in three stages—dysfunction of the spleen-stomach qi transformation pivot, impaired spleen nutrient transportation and transformation, and endogenous generation of phlegm-dampness, stasis, and turbidity—which correspond respectively to the modern pathological evolution of energy imbalance, insulin resistance, and multi-organ damage. Treatment centers on the core strategy of "activating the spleen and resolving turbidity", utilizing the Yunpi Huazhuo Decoction as the primary formula, while precisely selecting targeted medications based on specific metabolic components to form a comprehensive diagnostic and therapeutic system. This theoretical framework integrates classical TCM concepts with modern medicine, offering a valuable reference for the TCM treatment of MetS.