<p>Diabetes mellitus is one of the most common chronic diseases, with a global distribution. Its prevalence is constantly increasing, along with the rising incidence of diabetes-related complications such as diabetic nephropathy, neuropathy, and retinopathy. MicroRNAs are endogenous, non-coding RNAs that regulate gene expression at the post-transcriptional level. Evidence suggests that altered microRNA expression has been implicated in various human disorders, including diabetes mellitus. Dysregulated expression of microRNAs leads to insulin resistance, causing diabetes mellitus and its associated complications. Moreover, other non-coding RNAs, such as long non-coding RNAs and circular RNAs, along with epigenetic factors and altered gut microbiota, contribute to disease development. Because of the stability of non-coding RNAs in circulation, they have the potential to be used as biomarkers for diagnosis and therapeutic implications. Evidence suggests that a myriad of factors are involved; hence, a collective approach involving non-coding RNAs, epigenetic factors, and gut microbiota could provide the best clinical outcomes for diabetes patients.</p>