From the side of practical philosophy, evolutionary mismatch theory has been criticized as ideological because concepts of health and adaptation include not only descriptive, but also evaluative content. After having defended the possibilities of evolutionary mismatch theory in medicine in the previous chapter, this chapter now outlines limits of the theory with an eye on patient autonomy and potentially problematic instances of mismatch hypotheses. Despite these limitations, I once again defend the general relevance of evolutionary mismatch accounts for clinical purposes in the final section of this chapter.