"You Already Know" has been described as a song with 1990s house influences.
It samples "It Takes Two" by Rob Base and DJ E-Z Rock, which in turn samples the Lyn Collins 1972 song "Think (About It)".
Prior to the song's release, a lyric about Minaj's ex-boyfriend Meek Mill, was changed following their breakup in January 2017.
The song was performed live for the first time on Rock in Rio Lisboa on May 20, 2016.
Jordan Miller of Breathe Heavy reacted positively towards the song, calling it "fresh to death".