The insulin-like growth factor (IGF) system is an evolutionarily conserved group of important proteins that are fundamental to life. Indeed, insulin can be viewed as simply a specialized arm of the IGF system that has evolved to regulate primarily metabolic functions. The main purpose of the IGF system is to form a highly refined mechanism for the control of cellular growth, metabolism and survival. Dysregulation of such a system can have serious consequences. In this review we have focussed on the IGF system and its relation to diabetes and the development of cardiometabolic disorders.