Abstract <p>Diabetes remains one of the significant health struggles worldwide, leading to disability and mortality. There are several types, with Types 1 and 2 representing the majority of cases. Pancreatic beta cells play a key role in glucose control through the secretion of insulin. Insulin, a key player, is under-secreted in diabetes due to autoimmune destruction of the beta cells in type 1 diabetes and exhaustion of beta cell secretion in type 2. Hence, insulin plays a central role in the management of both conditions. Lifestyle modifications and pharmacological agents are significant components of managing diabetes, although they come with limitations; hence, the exploration of stem cells in diabetes management. A thorough literature search was conducted across several databases, identifying randomized and non-randomized controlled trials that utilized stem cells in patients with diabetes. The intervention details, primary and secondary outcomes, key findings, and safety profiles were documented and discussed. We explored key protocols and methods for generating pancreatic beta-like cells from stem cells, as well as the role of specific molecules and pathways in stem cell differentiation. In this paper, we also discuss preclinical animal studies, explore the challenges of immunogenicity, and address ethical concerns that limit the implementation of stem cells in clinical practice. A comparative analysis was conducted to evaluate conventional insulin therapy, islet transplantation, and stem cell-based approaches. Although stem cells represent a potentially valuable direction, their application clinically remains mainly experimental, and future studies should incorporate larger cohorts, diverse populations with varying comorbidities, and extended follow-up periods to better ascertain their long-term efficacy and safety.</p> Clinical trial number <p>Not applicable</p>