Nitrogen vacancy (NV) centers change their optical properties on the basis of their magnetic surroundings. Since optical signals can be detected more sensitively than small magnetic signals, this technique allows unprecedented sensitivity. Recently, NV center-based relaxometry has been used for measurements in living cells with subcellular resolution. The aim of this Outlook is to identify challenges in the field, including controlling the location of sensing particles, limitations in reproducibility, and issues arising from biocompatibility. We further provide an outlook and point to new directions in the field. These include new diamond materials with NV centers, other defects, or even entirely new materials that might replace diamonds. We further discuss new and more challenging samples, such as tissues or even entire organisms, that might be investigated with NV centers. Then, we address future challenges that have to be resolved in order to achieve this goal. Finally, we discuss new quantities that could be measured with NV centers in the future.