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Type 1 diabetes mellitus (T1DM) is a multifactorial disease wherein a genetic predisposition, upon exposure to environmental factors, triggers seroconversion and subsequent beta-cell destruction. The global incidence of T1DM has risen in recent decades, underscoring the significant role environmental factors play in actuating inherent genetic risk. However, the absence of an identifiable unique triggering factor complicates the identification of risk groups. Advances in bioinformatics and epigenetic research are opening new opportunities for early diagnosis, prevention, and novel therapies for the condition. A comprehensive analysis of complex molecular pathways will make it possible to develop algorithms for the early diagnosis, disease course prediction, and therapy personalization based on a patient's genetic profile. This review systematizes current data on the genetic and epigenetic heterogeneity of autoimmune diabetes and its potential triggers. It assesses the regional and ethnic disparities in T1DM incidence globally and within the Russian Federation, and it discusses the potential of clinical-genetic models for disease prediction.