The article reviews the cognitive dysfunction associated with diabetes mellitus, emphasizing the different stages of cognitive impairment and their clinical implications. It highlights that cognitive dysfunction in diabetes can range from subtle, slowly progressive changes in all age groups to more severe stages like mild cognitive impairment (MCI) and dementia, primarily affecting older individuals. The review discusses the evolving understanding of the underlying mechanisms, including risk factors, brain imaging, and neuropathology, and emphasizes the need to identify specific etiologies beyond Alzheimer's disease pathology. Experimental models are highlighted as valuable tools for further research, particularly in understanding non-Alzheimer's-related mechanisms contributing to cognitive decline in diabetes. The article also addresses the clinical implications of these findings, including the importance of early detection and management of cognitive impairment in patients with diabetes, and the need for targeted treatment and preventive strategies.The article reviews the cognitive dysfunction associated with diabetes mellitus, emphasizing the different stages of cognitive impairment and their clinical implications. It highlights that cognitive dysfunction in diabetes can range from subtle, slowly progressive changes in all age groups to more severe stages like mild cognitive impairment (MCI) and dementia, primarily affecting older individuals. The review discusses the evolving understanding of the underlying mechanisms, including risk factors, brain imaging, and neuropathology, and emphasizes the need to identify specific etiologies beyond Alzheimer's disease pathology. Experimental models are highlighted as valuable tools for further research, particularly in understanding non-Alzheimer's-related mechanisms contributing to cognitive decline in diabetes. The article also addresses the clinical implications of these findings, including the importance of early detection and management of cognitive impairment in patients with diabetes, and the need for targeted treatment and preventive strategies.