In adults, clinicians usually diagnose it after excluding other causes and finding at least two of these: signs of higher androgen activity, irregular or absent ovulation, or polycystic ovarian appearance on ultrasound.
NIH's PCOS overview summarizes these criteria.
Treatment depends on a person's goals and symptoms. It can include lifestyle support, medication to regulate periods or reduce acne/hair growth, treatment for insulin resistance, and fertility treatment if pregnancy is desired. PCOS is manageable, but it is also associated with higher risks of diabetes, abnormal uterine bleeding, and mood concerns, so regular medical follow-up matters.
NICHD explains symptoms and treatment.