The role of automated insulin delivery systems, also known as closed-loop systems or artificial pancreases, is expanding in the management of diabetes. These systems are increasingly being used in routine clinical practice for treating people with type 1 diabetes, with real-world data showing similar performance and usability to those observed in clinical trials. The review covers commercially available hybrid closed-loop systems, their distinctive features, and real-world data. It also discusses emerging indications for closed-loop systems, including the treatment of type 2 diabetes where day-to-day insulin requirements are highly variable, and other challenging applications such as in very young children with type 1 diabetes, pregnant women with diabetes, and individuals with impaired awareness of hypoglycemia. The psychosocial benefits of closed-loop systems are highlighted, including reduced diabetes distress, fear of hypoglycemia, and improved sleep quality. However, challenges in implementation, such as access to healthcare professionals, reimbursement policies, and user training, are discussed. The article also explores innovative approaches to improving the performance of closed-loop systems, such as integrating signals from other wearables and enhancing safety features. Overall, closed-loop systems are enabling more people with type 1 diabetes to reach recommended glucose targets, but further improvements in performance and safety are needed. The technology has the potential to bridge health outcomes gaps in underserved communities if access is equitable and unconscious bias is avoided.The role of automated insulin delivery systems, also known as closed-loop systems or artificial pancreases, is expanding in the management of diabetes. These systems are increasingly being used in routine clinical practice for treating people with type 1 diabetes, with real-world data showing similar performance and usability to those observed in clinical trials. The review covers commercially available hybrid closed-loop systems, their distinctive features, and real-world data. It also discusses emerging indications for closed-loop systems, including the treatment of type 2 diabetes where day-to-day insulin requirements are highly variable, and other challenging applications such as in very young children with type 1 diabetes, pregnant women with diabetes, and individuals with impaired awareness of hypoglycemia. The psychosocial benefits of closed-loop systems are highlighted, including reduced diabetes distress, fear of hypoglycemia, and improved sleep quality. However, challenges in implementation, such as access to healthcare professionals, reimbursement policies, and user training, are discussed. The article also explores innovative approaches to improving the performance of closed-loop systems, such as integrating signals from other wearables and enhancing safety features. Overall, closed-loop systems are enabling more people with type 1 diabetes to reach recommended glucose targets, but further improvements in performance and safety are needed. The technology has the potential to bridge health outcomes gaps in underserved communities if access is equitable and unconscious bias is avoided.