Diabetes-induced male infertility is a complex issue involving multiple physiological mechanisms. This review summarizes recent research on the effects of diabetes on male reproductive function, the potential pathophysiological mechanisms of male infertility caused by diabetes, and therapeutic measures. Male infertility is defined as the inability of a man to impregnate a fertile woman within a 12-month period of continuous, unprotected sexual intercourse. Clinical and epidemiological evidence indicates that the increasing incidence of male reproductive problems, especially infertility, shows a similar trend to the incidence of diabetes in the same age group. In vivo and in vitro experiments suggest that diabetes can induce male infertility through various mechanisms, including hypothalamic-pituitary-gonadal (HPG) axis dysfunction, spermatogenesis and maturation disorders, and testicular interstitial cell damage. These mechanisms are closely related to hyperglycemia, oxidative stress, chronic inflammation, mitochondrial dysfunction, and endoplasmic reticulum (ER) stress. The review also discusses the potential therapeutic measures for diabetes-induced male infertility, including drug therapy, exercise, mesenchymal stem cell therapy, and microbial therapy. Insulin, resveratrol, metformin, pioglitazone, and Chinese herbs are among the drugs that have shown potential in improving male fertility. Exercise and mesenchymal stem cell therapy have also been shown to improve testicular and sperm function. Microbial therapy, such as fecal microbiota transplantation, has shown promise in improving the testicular microenvironment. The review concludes that while the association between diabetes and male infertility is well established, more research is needed to develop effective treatments. The review highlights the importance of understanding the complex pathophysiological mechanisms of diabetes-induced male infertility and the potential therapeutic measures to address this issue.Diabetes-induced male infertility is a complex issue involving multiple physiological mechanisms. This review summarizes recent research on the effects of diabetes on male reproductive function, the potential pathophysiological mechanisms of male infertility caused by diabetes, and therapeutic measures. Male infertility is defined as the inability of a man to impregnate a fertile woman within a 12-month period of continuous, unprotected sexual intercourse. Clinical and epidemiological evidence indicates that the increasing incidence of male reproductive problems, especially infertility, shows a similar trend to the incidence of diabetes in the same age group. In vivo and in vitro experiments suggest that diabetes can induce male infertility through various mechanisms, including hypothalamic-pituitary-gonadal (HPG) axis dysfunction, spermatogenesis and maturation disorders, and testicular interstitial cell damage. These mechanisms are closely related to hyperglycemia, oxidative stress, chronic inflammation, mitochondrial dysfunction, and endoplasmic reticulum (ER) stress. The review also discusses the potential therapeutic measures for diabetes-induced male infertility, including drug therapy, exercise, mesenchymal stem cell therapy, and microbial therapy. Insulin, resveratrol, metformin, pioglitazone, and Chinese herbs are among the drugs that have shown potential in improving male fertility. Exercise and mesenchymal stem cell therapy have also been shown to improve testicular and sperm function. Microbial therapy, such as fecal microbiota transplantation, has shown promise in improving the testicular microenvironment. The review concludes that while the association between diabetes and male infertility is well established, more research is needed to develop effective treatments. The review highlights the importance of understanding the complex pathophysiological mechanisms of diabetes-induced male infertility and the potential therapeutic measures to address this issue.