I went for my first consult about two weeks ago and I can’t wait for my surgery date!!! My insurance requires the 90 day nutrition counseling and I will go back mid January. The nutritionist had me set goals on being a more mindful eater and to start logging food but nothing else. She didn’t seem concerned about me losing any weight before the surgery (I assume it’s because I’m closeish to the cut off for insurance coverage). Has this been the case for anyone else? Should I be worried about insurance not covering me if I gain weight in the 90 days? Any insight or advice would be great!

It really depends on your situation, your insurance (down to the specific plan, not just carrier), and your surgical team.

This is a personal anecdote, but I was close to the cutoff the whole time, but actually gained about 20lbs through the first 3 months of my 6 month diet because I have Rheumatoid Arthritis and had to be on a 3 month course of steroids. Nobody on my team was all that concerned, but they did make it clear that in the last 3 months they wanted to see some kind of change - statistically, you are more likely to have a successful surgical resolution if you manage to lose even a little bit of weight beforehand. Side note, most insurances, when you apply for surgery, take into account only your pre-op BMI.

Some real tips I found helpful - start focusing on protein and getting in 50-70 grams of protein a day. It is good practice for post op.
Buy a bunch of different protein shakes (look for shakes that are low in calories and very low in carbs/sugar and high in protein) and try them. Find a set few that you think you like and start incorporating those into your diet, but be sure to give yourself kind of a selection after surgery because what worked for you pre-op might not work post-op.
Logging and mindful eating with actual goals is huge. You should be logging after surgery until you can reliably get in your 70-80 grams of protein per day, so getting in that habit is super important.