Diabetes mellitus(DM) is a metabolic disease characterized by blood glucose elevation due to insulin deficiency.Insulin resistance(IR) leads to relatively insufficient insulin secretion and impaired utilization; the decline in the function of pancreatic beta cells leads to absolute insufficient insulin secretion and blood sugar accumulation.The clinical curative effect of traditional Chinese medicine(TCM) on hypoglycemia is definite，but the mechanism remains to be elucidated.TCM may improve IR and protect the function of pancreatic beta cells through multiple channels and multiple targets，thereby improving glucose and lipid metabolism and treating diabetes.Based on the research literature on hypoglycemia of TCM(active ingredients of TCM，single herbal medicine，and compound prescription) in recent ten years，this article systematically sorted out and summarized the potential hypoglycemic mechanism of TCM by focusing on anti-oxidative stress，anti-inflammation，regulation of glucose transport pathways，regulation of intestinal flora，inhibition of ectopic lipid deposition，and inhibition of adipose tissue macrophage exosomes to improve IR，stimulate insulin secretion，and regulate pancreatic beta cell differentiation，injury，apoptosis，and regeneration，so as to protect pancreatic beta cell function.Based on the current research field of the hypoglycemic effect of TCM，this article analyzed the existing problems，explored the future development trend and direction，and provided a reference for further exploration of basic research on the treatment of DM with TCM.