Precision fermentation leverages microbial cell factories to produce high-value functional food ingredients at high yields and purity with lower environmental footprint. Metabolic engineering, a major subset of precision fermentation, incorporates precision methods such as next-generation sequencing, high-throughput library screening, molecular cloning and multiomics to optimise microbial strains, metabolic pathways, product yields, and bioprocess scale-up. This review focuses on yeasts, moulds and macrofungi used in precision fermentation, highlighting their chassis strengths and important recently commercialised products, for example, soy leghemoglobin and alternative proteins. The implementation of precision methods into traditional fungal food fermentations to improve their efficiency, safety, nutrition, flavour, and overall quality is also discussed herein. Such methods include high-throughput screening, Crispr-Cas9, and global transcription machinery engineering.