This song is about a friend of frontman Dom Ganderton. He told NME: "At uni, he got into the routine of waking up at 5 p.m. and smoking, then staying up until 4 a.m. and doing the same thing over and over. It's saying, 'Get your s--t together and do something.' He has now: he's moved to Prague to work."
Fall Out Boy's "The Kids Aren't Alright" song title is not a reference to The Offspring's 1998 single of the same name. It actually alludes to The Who's 1979 rockumentary film called The Kids Are Alright.