If you’ve ever swallowed an aspirin, put milk in your coffee, fed your pet, or filled a prescription, then you trusted the oversight of the U.S. Food and Drug Administration that saved your life. Long considered the global gold standard in food and medicine regulation, the FDA is a behemoth that oversees products that account for roughly a quarter of the U.S. economy.
Even on the best of days, the FDA commissioner (a Senate-confirmed position) must wander through a merciless wilderness of excruciating decisions, whether it’s the record-speed approval of Covid-19 vaccines or the minefield of mail-order birth control pills, all while fending off powerful companies hoping for VIP treatment.
Doing the job well, or even doing it at all, is not a friendship-building exercise.
After days of being dangled like a cat toy between warring parties in the White House and the Department of Health and Human Services, which oversees the FDA, news broke Tuesday that President Donald Trump’s embattled FDA commissioner, Johns Hopkins surgeon Dr. Marty Makary, was signing on.
Attention immediately focused on the question of which prominent medical figure could fill the position. Shortly after Trump published Makary’s resignation text in Truth Social, Kyle Diamantas38, an obscure Florida lawyer who first came to the FDA in 2025 as director of the human foods program, following his previous role as Don Jr.’s hunting partner, was named acting FDA commissioner.
In March 2021, Don Jr. and Diamantas posed holding dead Osceola wild turkeys. as first reported. Mike Tusey, the founder of the hunting group Osceola Outdoors, described the scene in X like: “Don Jr. with his good friend Kyle Diamantas! Kyle’s first Osceola!” A photo of Trump Jr., Diamantas and Tussey, with a single turkey, appears on the Osceola Outdoors website.
How you go from turkey hunting with the president’s son to supervising 1,000 employees in the FDA’s human food program to serving as acting FDA commissioner is a story whose contours have become familiar throughout the second Trump administration, where being friends with the right people is a qualification in itself.
It is perhaps a testament to the current state of the FDA that Diamantas was the only deputy commissioner who could credibly take on the role, says Susan Mayne, an associate professor at the Yale School of Public Health, who served as the FDA’s director of food safety and applied nutrition from 2015 to 2023. “Mr. Diamantas is not a doctor. It’s an unusual choice. But under the circumstances, it’s the logical choice.”
After DOGE staff cuts devastated the agency and constant turmoil led scientists to leave en masse, the FDA’s organizational chart was stripped of leadership. And in an FDA ravaged by diva-style personnel eruptions, Diamantas had a “more balanced leadership style,” Mayne says.
In what should have been a sober regulatory environment, under Makary, chaos was often the headline. There was the director of the Center for Drug Evaluation and Research, George Tidmarsh, who was forced to resign, after allegedly using his regulatory role within the agency to carry out a vendetta against a former business partner.
And there was Vinay Prasad, director of the FDA’s Center for Biologics Evaluation and Research, who shook the pharmaceutical industry (and his own staff) with an abrasive leadership style and peremptory rejection of certain drug applications.
Amid countless battles, it was ultimately a fight over fruit-flavored vapes that ended Makary’s tenure, after Trump had a “fateful lunch” with tobacco industry executives seeking approval for his products, an FDA official says.
The White House was putting pressure on the FDA to approve the products, and Makary was resisting, since such products would clearly appeal to children. “For him it was the end of the rope,” says an associate of Makary. “I didn’t want to approve candy flavors.”
But he eventually signed, even though it was too late to save his job. Trump thanked him Tuesday in a social media post, writing, “He was a hard worker, respected by everyone, and will have an outstanding career in Medicine.”
Diamantas holds the position on a temporary basis for now, and anyone chosen to fill it permanently would have to appear for Senate confirmation hearings. One name that has emerged as a possible candidate is Admiral Brett Giroir, a pediatrician who served as deputy secretary of health at HHS during the first Trump administration and oversaw diagnostic testing during the Covid pandemic. Giroir, reached by rolling stone Tuesday, he declined to comment.
However, it’s unclear if or when Trump will nominate anyone, and it’s unclear how long Diamantas might end up overseeing the FDA on an interim basis.
