omg fr I always hate how alphas can make out with other people and possibly get them pregnant but once an omega got fucked by an alpha they were supposed to stick with the very same alpha that got them pregnant/marked. It's misogyny all over again, omega is usually feminine and alpha is usually masculine like men irl
lol your really sweet. My take on medieval omegaverse is chained in the alphas home and treated worse than a slaves because when they go into heat they are treated like whores. They are probably always pregnant and depressed. When an alpha is in rut he attacks one person and are hostile to everyone else (so the betas treat omegas like the sacrifice for the greater good since “they probably want it anyway”). I think it’s recent that omegas got rights.
Funnily enough it's origin was the Supernatural rape fandom. Stuff like pheromones were added later in east asian countries, a visible mark other people can see, and all this Omega needs Alpha stuff, it's cultural stuff.
No society would've survived with this - it's completely unplausible why only humans would evolve another sex, and bodily changes happen in days where it normally would take years. You don't know if he's an Omega? Godammit make a fucking X-Ray from his stomach. When you can see a womb he's an Omega, when you cannot see a womb no womb will be there for the rest of his life.

It's always bothered me how one sided it is. The alpha never needs a specific omega, it's always the omega that needs the alpha's pheromones. How has that kind of species not gone extinct yet? Are they super monogamous? The alpha's lack of physical investment suggests otherwise, the top doesn't feel the same issues as MC does. If he hadn't decided to pursue MC, had been a deadbeat or even just got isekai'd, is MC supposed to roll over and die, or lose his baby? Even if MC has some pheromone issues, the doctor talks as though it's expected to always have the dad on speed dial and tending to the mom.
And this is in the modern day, how did their species even survive that long, do they not lose alphas in wars or accidents? afaik, men tend to die younger than women once childbirth issues are taken out, what happens to single moms in the medieval omegaverse? I get the feeling the reason betas exist is so the species continues to survive somehow. I guess you could also appoint therapy alphas who have no purpose but to stay around multiple omegas who have lost their imprinted alpha. That's one step up from being a breeding stud/harem, i suppose.