Diabetes Mellitus is a chronic disease with increasing prevalence worldwide, significantly impacting patients' physical, psychological, social, and spiritual well-being. Conventional medical approaches have limitations in providing a holistic solution, thus highlighting the need for integrative strategies that improve patients' quality of life. This review aims to explore the implementation of the Tri Hita Karana concept, a Balinese philosophy that considers harmony between humans and God (Parhyangan), humans and others (Pawongan), and humans and the environment (Palemahan) in the management of diabetes mellitus. Using a qualitative review method, this study analysed literature and case studies related to the integration of spiritual, social, and environmental dimensions in the care of chronic diseases. Findings indicate that adopting Tri Hita Karana fosters better self-management, enhances treatment adherence, and provides stronger social support networks while promoting psychological resilience and spiritual coping. Furthermore, the environmental aspect encourages healthier lifestyle practices aligned with natural balance. The integration of this philosophy into healthcare practice not only strengthens patient-centred care but also supports culturally sensitive interventions in primary health services. In conclusion, Tri Hita Karana offers a transformative, holistic framework that can significantly improve the quality of life for patients with diabetes mellitus. Future studies are recommended to develop culturally adaptive models and interventional designs to optimise their application in clinical and community health settings.