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According to scientific realism, science gives us an approximately true description of what the world is like. But what does it mean? In this chapter, we focus on the ontological and metaphysical aspects of this discussion. That is, we are concerned with the following questions: what there is, according to our best scientific theories? And how are these things that theories say exist? We start from the assumption that a genuine scientific realism must deal with these issues. Taking non-relativistic quantum mechanics as a case study, we discuss some of the challenges currently faced by a genuinely realistic stance. We argue, first, that in the ontological aspect, realists are in the same boat as science, that is, without sufficient epistemic justification to adopt the belief in the entities postulated by a single quantum theory, given that experience (currently) is not able to decide between rival theories; in the metaphysical aspect, realists also encounter problems with theory choice, given the possibility of associating more than one metaphysical theory with the description of the entities postulated by each quantum theory. The same goes for structuralist alternatives, since, even if we accept that scientific theories are committed to the existence of structures, but not objects, we still do not know what structures are, metaphysically. Finally, we move forward in the discussion with the meta-Popperian method, which serves to reduce the metaphysical alternatives associated with the ontological postulates of scientific theories. We may not know what the correct alternative is, but we have been able to progressively check which metaphysical alternatives are incompatible with each scientific theory.