Changes of intestinal microecology affect the host energy metabolism to participate in the occurrence of diabetes.This paper analyzes the role of intestinal flora in the pathogenesis of diabetes from the perspective of traditional Chinese medicine,and holds that “the congenital foundation and the foundation of acquired constitution” involves in the formation and distribution of intestinal flora.On the other hand,the intestinal flora functionally helps the kidney to promote the gasification,determines one's endowment,helps the spleen to transport and ascend clear and and helps the stomach to propell food downward.Therefore,in the pathological state,kidney deficiency,stomach excess,and spleen weakness can lead to diabetes by inducing intestinal flora disorders.In terms of treatment,whether it is the single herb or compound prescription with the function of enriching yin and nourishing kidney,clearing heat and invigorating spleen,or the concept of low-calorie diet,it is not only confirmed by modern research that it can improve glucose homeostasis by regulating the structure of intestinal flora,but also in accordance with the pathogenesis of diabetes recognized by traditional Chinese medicine,indicating that it has potential application value and development prospect to treat diabetes with intestinal flora as the target from “the congenital foundation and the foundation of acquired constitution”.