This paper demonstrates that maternal nutrition intervention (MNI) coverage was consistently lower than antenatal care (ANC) coverage in Bangladesh, Burkina Faso, Ethiopia, and India, despite ANC being the largest global platform to deliver MNI. Examination of the incorporation of MNI into national policies and programs, and the nutrition content of ANC protocols against global recommendations reveal barriers, missed opportunities, and gaps in coverage and quality of maternal nutrition services. Authors recommend specificity in ANC national protocols for micronutrient supplements, weight gain monitoring, counseling on diets, and counseling in breastfeeding, and guidance on accountability for delivering services, as well as further explore health system gaps, barriers, and enabling factors to MNI delivery.