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Maternal diabetes, encompassing gestational diabetes mellitus and pre-existing type 1 and type 2 diabetes are associated with adverse perinatal outcomes. Emerging evidence suggests that maternal hyperglycemia and insulin resistance may be associated with long-term neurodevelopmental outcomes, particularly increasing the risk of autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD). This review synthesizes current epidemiological and mechanistic evidence linking maternal diabetes with the incidence of ASD and ADHD in offspring. Large population-based cohort studies consistently demonstrate an elevated risk of ASD and ADHD among children exposed to maternal diabetes in utero, with risk magnitude varying according to diabetes type, timing of diagnosis, and treatment modality. ADHD appears to show a stronger and more consistent association, particularly in offspring of mothers with type 1 diabetes. Proposed biological mechanisms include hyperglycemia-induced oxidative stress, epigenetic modifications, hormonal dysregulation involving estrogen, progesterone, and androgens, and an increased incidence of preterm birth. Maternal factors such as obesity, advanced age, and fertility treatments further modulate risk. Despite accumulating evidence, heterogeneity across studies and residual confounding limit causal inference. Future prospective studies integrating detailed glycemic profiling, hormonal assessments, and neurodevelopmental phenotyping are required to elucidate underlying mechanisms and inform preventive strategies for pregnancies complicated by diabetes.