Despite the critical role academic medical institutions play in promoting equity and inclusion, these efforts are often undermined by fragmented and siloed evaluation approaches, a lack of theory-driven models, and inadequate data-driven methodologies. This commentary critically examines the factors contributing to the persistent challenges in implementing and advancing equity and inclusion initiatives in the United States (U.S.), focusing on academic medical institutions in particular. It underscores the need for theory-guided frameworks to better structure and evaluate such initiatives and highlights existing gaps in accountability and data-driven decision-making. Moreover, it argues for an integrated approach that combines multidisciplinary strategies, promoting collaboration across different sectors to develop more comprehensive and sustainable solutions. Ultimately, effective evaluation – grounded in data, theory, and diverse perspectives – is essential for promoting equity and inclusion and addressing disparities in U.S. academic medical institutions. By addressing these structural and evaluative shortcomings, institutions can move towards more impactful and equitable outcomes for underrepresented groups in STEM fields and the biomedical workforce more broadly.