<p>Nanosuspension is an emerging and effective approach that can overcome issues related to diabetes and its associated complications by improving the pharmaceutical characteristics of poorly water-soluble antidiabetic agents. Nanosuspension is nano-sized colloidal dispersions of therapeutic agents that are stabilized with the help of surfactants, polymers, or both, offering a promising solution that enhances the solubility, absorption, dissolution rate, and therapeutic potential of antidiabetic agents. This article highlights the potential of nanosuspension, in improving glycemic control and managing diabetes-related complications such as diabetic retinopathy, diabetic foot ulcer, and diabetic cerebrovascular disease. Key nanosuspension preparation techniques, including high-pressure homogenization, emulsification solvent evaporation, media milling, precipitation, and supercritical fluid methods are discussed to optimize drug delivery. The relevance of nanosuspension in personalized diabetes is also examined, particularly in delivering anti-diabetic agents, phytoconstituents, and other novel therapeutic agents. Despite their advantages, challenges such as scalability, stability, and regulatory considerations remain. The article provides an overview of recent developments, ongoing challenges and future directions to support nanosuspension-based strategies in effective diabetes management.</p> Graphical abstract <p></p>