Extreme adaptive optics (AO) systems are now in operation across the globe. These systems, capable of high order wavefront correction, deliver Strehl ratios of ~90% in the near-infrared. Originally intended for the direct imaging of exoplanets, these systems are often equipped with advanced coronagraphs that suppress the on-axis-star, interferometers to calibrate wavefront errors, and low order wavefront sensors to stabilize any tip/tilt residuals to a degree never seen before. Such systems are well positioned to facilitate the detailed spectroscopic characterization of faint substellar companions at small angular separations from the host star. Additionally, the increased light concentration of the point-spread function and the unprecedented stability create opportunities in other fields of astronomy as well, including spectroscopy. With such Strehl ratios, efficient injection into single-mode fibers (SMFs) or photonic lanterns becomes possible. With diffraction-limited components feeding the instrument, calibrating a spectrograph’s line profile becomes considerably easier, as modal noise or imperfect scrambling of the fiber output are no longer an issue. It also opens up the possibility of exploiting photonic technologies for their advanced functionalities, inherent replicability, and small, lightweight footprint to design and build future instrumentation. In this work, we outline how extreme AO systems will enable advanced photonic and diffractionlimited technologies to be exploited in spectrograph design and the impact it will have on spectroscopy. We illustrate that the precision of an instrument based on these technologies, with light injected from an efficient SMF feed would be entirely limited by the spectral content and stellar noise alone on cool stars and would be capable of achieving a radial velocity precision of several m/s; the level required for detecting an exo-Earth in the habitable zone of a nearby M-dwarf.