the short answer
VO2 max is the maximum rate at which the body can take in, deliver, and use oxygen during hard exercise - usually expressed in millilitres of oxygen per kilogram of body weight per minute. Because endurance performance depends on getting oxygen to working muscles, it is treated as the gold-standard single measure of aerobic fitness. It is driven mainly by genetics, age, and training, and it improves with a mix of easy aerobic volume and intervals.
This article is general coaching information, not medical advice - VO2 max is a fitness marker, not a diagnosis. Individual needs vary, and any client with a heart condition, chest pain, dizziness on exertion, or other health concerns should be cleared by a doctor before maximal-effort testing or hard interval training.