It's shown efficacy as a treatment for PCOS (e.g. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7028834/ ).
Berberine is actually quite interesting: it's available OTC and is widely taken by healthy people supplementing for anti-aging purposes[1] who either can't or don't want to get their doctor to prescribe metformin. I take a gram a day (I don't have any morbidities that would justify a metformin prescription) and don't notice any side effects.
[1] Both berberine and metformin are AMPK activators which helps with a wide range of things in the body such as maintaining insulin sensitivity, fat burning, mitochondrial homeostasis, cancer protection.