High Variety Low Volume (HVLV) context sets novel requirements for the decision support environment. The coexistence of engineering-to-order or engineering-to-delivery design alongside modular and platform design necessitates the integration of multi-disciplinary models. This paper provides a comprehensive review of existing model-driven and simulation-driven decision support systems, aiming to identify pertinent directions for tailoring decision support systems to meet the needs of practitioners in sales and engineering phases within High Variety Low Volume (HVLV) projects. This study identifies the following development needs: 1) accessibility of data and results to a broader user base, 2) guidelines for interacting with the decision environment without specialized expertise, 3) real-time feedback to decision-making teams, 4) metrics to gauge the maturity level or reliability of the models and 5) change management of the dependency models and calculation models. These are the next steps toward supporting decision-making in complex engineering situations under time pressure.