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Diabetes, particularly type 2 diabetes, poses a significant public health challenge globally, with an especially pronounced impact in China. The prevalence of diabetes in China has surged from 2.5% in 1994 to 13.0% in 2021, with projections indicating a continued upward trend. This review provides a comprehensive overview of the diabetes burden in China and underscores the urgent need for effective prevention and control measures. We examine the epidemiology of diabetes, highlighting the rising prevalence of prediabetes, type 1 and type 2 diabetes, youth-onset diabetes, and gestational diabetes mellitus, as well as diabetes-related complications, including both macrovascular and microvascular complications, and emerging conditions like cancer, infectious disease, fatty liver disease, and dementia. Key risk factors, including genetic susceptibility, obesity, dietary factors, and physical activity, are discussed, with particular attention to how these factors manifest differently in Chinese versus western populations. The review highlights advancements in national prevention efforts, innovative diabetes management models, and emerging technological innovations. The review also addresses advancements in pharmacological therapies, including the introduction of novel glucose-lowering agents such as GLP-1 receptor agonists, and SGLT2 inhibitors, which offer both metabolic and cardio-renal benefits. However, significant challenges remain, including the underrepresentation of the Chinese population in current research, persistent regional disparities, gaps in primary healthcare capacity, and the need for better integration of new technologies into clinical practice.