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Obesity, diabetes, and hypertension are major global health burdens influenced not only by lifestyle factors but also by genetic predisposition, sleep quality, chrononutrition, and circadian rhythms. This review examined how these factors interact in metabolic and cardiovascular diseases, with emphasis on sex-specific differences. A narrative review was conducted using PubMed, Scopus, and Web of Science databases for studies published between 2006 and 2026. A total of 112 studies were synthesized, including randomized trials, observational studies, systematic reviews, meta-analyses, Mendelian randomization, and mechanistic investigations. Evidence indicates that genetic susceptibility and circadian disruption contribute significantly to obesity, diabetes, and hypertension. Sleep deprivation, obstructive sleep apnea, and circadian misalignment were consistently associated with insulin resistance, appetite dysregulation, elevated blood pressure, and increased cardiometabolic risk, particularly among shift workers. Hormonal and metabolic pathways involving leptin, ghrelin, cortisol, and melatonin appear to mediate these effects. Important sex differences were observed, with women showing greater vulnerability to sleep-related appetite disturbances and men presenting a higher prevalence of visceral adiposity, sleep apnea, and hypertension. Chrononutrition strategies, including time-restricted eating and Mediterranean dietary patterns, showed beneficial effects on sleep quality, glycemic control, inflammation, and metabolic health. Emerging evidence also suggests bidirectional interactions between gut microbiota rhythmicity and circadian regulation. Genetic predisposition, sleep disturbances, and circadian disruption interact to influence metabolic and cardiovascular disease risk. Integrative approaches combining chrononutrition, sleep hygiene, circadian alignment, and personalized nutritional strategies may improve the prevention and management of cardiometabolic diseases.