Background <p>Diabetes mellitus, a global epidemic, necessitates robust evidence synthesis to guide clinical practice. This study analyzes systematic reviews and meta-analyses in diabetes research to identify trends, gaps, and key insights for advancing diabetes management.</p> Methods <p>We analyzed 10,714 systematic reviews and meta-analyses on diabetes mellitus, published between 1988 and 2024, sourced from Scopus. Publication trends, collaboration networks, and research clusters were examined using VOSviewer and Scimago Graphica.</p> Results <p>Research output surged post-2011, with China leading overall (3,241 publications, 30.25%), followed by the United States (1,915, 17.87%) and the United Kingdom (1,560, 14.56%). Twelve clinical clusters emerged, including therapeutics (e.g., metformin, dual-agonist therapies), cardiovascular outcomes, lifestyle factors, mental health, maternal health, and bone health. High-impact studies underscored vascular complications, mental health links, and gestational diabetes risks, shaping practice. Recent trends emphasize dual-agonist therapies like Tirzepatide, digital health, and weight management, while gastric bypass surgery, bone mineral density, and maternal health reflect enduring influence. Research shifted from early methodological approaches to later comorbidity-driven studies, yet low- and middle-income country (LMIC) contributions remain limited.</p> Conclusion <p>This study illuminates a dynamic evidence base for diabetes mellitus, spanning decades of impactful clinical research and emerging innovations. However, disparities in LMIC representation and insufficient long-term evaluations of novel therapies limit its global applicability. Future research must prioritize LMIC populations and sustained efficacy studies to strengthen diabetes management strategies worldwide.</p>