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Insurance defines Des Moines more than any other industry, accounting for roughly 16% of the region's jobs across more than 80 companies. Principal Financial Group and EMC Insurance Companies have been headquartered there for over a century, and Wellmark Blue Cross Blue Shield, Nationwide, and Wells Fargo maintain significant operations locally. Beyond insurance, the metro's major employers span agbioscience, advanced manufacturing, logistics, and technology, with Ruan Transportation and Kemin Industries both headquartered in the city.

Downtown's Historic East Village has become a retail and dining district built around design firms, restaurants, and independent shops, while MercyOne runs two hospitals and a network of medical facilities in Des Moines. Meredith Corporation, the media company, is also headquartered locally. The metro has consistently outpaced Midwest peers in population and GDP growth, with a cost of doing business cited as roughly 17% below the national average.

With insurance and financial firms clustering downtown and healthcare systems like MercyOne anchoring their own campuses, Des Moines has real demand for the professional-adjacent services that support office-heavy employers, commercial cleaners, IT and electrical contractors, and lawyers or accountants serving a corporate base, alongside the plumbers and HVAC companies keeping pace with the metro's above-average population growth.