Diabetic kidney disease (DKD) is a form of kidney damage resulting from diabetes and represents a common, severe complication of the disease. Globally, DKD is a leading cause of chronic kidney disease (CKD). DKD occurs in both type 1 and type 2 diabetes patients, with early clinical manifestations including microalbuminuria and hypertension. As the condition progresses, symptoms such as massive proteinuria, hypoalbuminemia, and severe edema may appear. The key to treating DKD lies in controlling blood glucose and blood pressure, reducing proteinuria, and slowing the deterioration of kidney function. Acupuncture, a traditional Chinese medicine treatment, has shown some therapeutic effects on DKD through mechanisms such as regulating blood glucose, improving renal blood flow and microcirculation, antioxidation and anti-inflammation, and modulating gut microbiota.