Abstract [Innovative Microneedle Transdermal Patches for Diabetes Mellitus Management: A Narrative Review]. This narrative review summarizes recent advances in microneedle transdermal patches for diabetes mellitus, highlighting design innovations, material selection, glucose-responsive mechanisms, preclinical efficacy, and translational barriers. Methods comprised literature searches on Google Scholar, PubMed, PMC, Scopus, and ScienceDirect performed between April-August 2025; inclusion criteria targeted original studies published from 2015 to 2025 that focused on microneedle applications in type 1 and type 2 diabetes. Seventeen original articles were selected for descriptive analysis. Results indicate predominant utilization of biodegradable polymers (hyaluronic acid, gelatin, carboxymethyl cellulose) combined with smart components such as glucose oxidase, phenylboronic acid, and mesoporous nanoparticles. Device formats include dissolving and hollow microneedles as well as biosensor-integrated systems with micropumps, evidencing a trend toward closed-loop platforms. Preclinical findings report improved pharmacokinetics (intradermal Tmax ? 35 min versus subcutaneous ? 87.5 min), extended glycemic control (>20 hours in minipigs; 1–2 days in mice), and dual-hormone approaches to reduce hypoglycemia risk. Major challenges remain: enzyme stability and byproduct toxicity (e.g., H?O?), mechanical robustness of microneedles, scarce human clinical data, and high manufacturing complexity and cost. In conclusion, microneedle patches represent a promising minimally invasive and adaptive platform for diabetes therapy, but multidisciplinary research, long-term clinical evaluation, and scalable manufacturing innovations are essential for broad clinical translation.. Keywords: Microneedle patch, Microneedle innovation, Transdermal delivery, Diabetes therapy.