Diabetes mellitus is a major public health challenge with high prevalence and mortality rates. Polyphenols, as natural active components, have shown potential in the prevention of type 2 diabetes mellitus (T2DM). Since polyphenols mainly regulate target genes by modulating miRNA expression, the various functions of polyphenol-mediated miRNA regulation of target genes were classified and summarized. Although the current understanding of their regulatory mechanisms and functions still needs to be deepened, polyphenol-mediated miRNA-targeted regulation provides new theoretical basis and potential strategies for the prevention and treatment of diabetes. Future research should combine multi-omics technologies to further clarify their mechanisms of action and explore their potential for personalized applications.