Abstract： Microangiopathy,a common and specific complication of diabetes mellitus,significantly impairs the functioning of various organs in patients.Extensive research has demonstrated the crucial role of gut microbiota in human metabolism and immune regulation.Alterations in gut microbiota composition can disrupt the gastrointestinal environment,leading to abnormal production of metabolites,inflammatory conditions,disturbances in glucose metabolism,and even insulin resistance.Type 2 diabetes mellitus(T2DM)patients often experience metabolic disorders and chronic inflammation accompanied by disruptions in intestinal microbiota.Changes in the stable community of intestinal microbiota have a profound impact on the prognosis of diabetic microvascular compli-cations.This review aims to summarize the characteristics and pathogenesis of intestinal microbiota in diabetic microangiopathy,providing a solid theoretical foundation for regulating intestinal microbiota as an approach for preventing and treating T2DM and related microangiopathic conditions.