Childhood diabetes mellitus is one of the most common chronic endocrine disorders of childhood, and it encompasses type 1 diabetes (T1D), type 2 diabetes (T2D), and monogenic forms. The global incidence of childhood diabetes has been on a steady rise over the past three decades, with significant increases noted in low- and middle-income countries. Globally, although T1D remains the predominant form, the prevalence of T2D is rising in parallel with childhood obesity. In addition, advances in genetic technology have also led to recognition of monogenic diabetes. Despite improvements in insulin therapy and diabetes technology, optimal management remains challenging due to unique developmental, physiological, and psychosocial needs in children. The pathophysiology of the various types of diabetes varies across the subtypes, ranging from autoimmune β-cell destruction in T1D to insulin resistance and β-cell failure in T2D and single-gene defects in monogenic forms. Clinical presentation is often symptomatic in children, with a significant proportion presenting in diabetic ketoacidosis. Management principles primarily aim at maintaining euglycemia through lifestyle modification, insulin therapy, oral antidiabetic drugs, diabetes technology, psychosocial support, and structured education tailored to both the patient and families. The resource-limited settings in some parts of the world, in addition, have unique challenges, like psychosocial stressors leading to a lack of adherence to therapies and limited access to therapies. Nevertheless, long-term care should focus on growth, development, comorbidities, and transition to adult services. A multidisciplinary, family-centered approach is mandatory to optimize outcomes and reduce complications.