Type II diabetes mellitus (T2DM) is a group of metabolic diseases characterized by hyperglycemia, and it will cause a variety of complications. Through the research on Danggui-Shaoyao-San (DSS), scholars found that it has an active role in the treatment of diabetes and some complications. Danggui-Shaoyao-San polysaccharide (P-DSS) is the main component of Danggui-Shaoyao-San. P-DSS can participate in the physiological regulation of oxidative stress, anti-inflammatory, glucose and lipid metabolism, endoplasmic reticulum stress, bile acid metabolism and iron metabolism, especially bile acid can effectively regulate the disorder of glucose and lipid metabolism in the body, which provides a new idea for the treatment of diabetes. In addition, the therapeutic effect of P-DSS on diabetic complications may also be related to cell autophagy and intestinal flora, but there is little systematic analysis on the mechanism of P-DSS in treating diabetes and its complications. Therefore, this article reviews the potential mechanism of P-DSS in treating diabetes and its complications in detail, providing a reasonable theoretical basis for further research on P-DSS in treating T2DM.