In recent years, the global incidence of diabetes mellitus has been on a steep rise, with diabetic kidney disease（DKD）, one of the most prevalent microvascular complications, emerging as the primary cause of end-stage renal disease (ESRD). DKD patients often present with comorbidities such as cardiovascular diseases, which exacerbate their clinical status and mortality risk. Consequently, there is an urgent need to identify safe, reliable, cost-effective, and low-side-effect medications for early DKD intervention to delay disease progression. Pathological studies have revealed that the adenylate-activated protein kinase (AMPK) signaling pathway plays a central role in DKD pathogenesis, offering a novel therapeutic direction by regulating inflammatory responses, oxidative stress, autophagy, apoptosis, lipid metabolism, ferroptosis, and other biological processes.The integration of the "holistic concept" and "evidence-based treatment" is a cornerstone of Traditional Chinese Medicine (TCM), which has demonstrated unique clinical advantages in DKD management. TCM has been shown to effectively alleviate edema, proteinuria, and renal function decline, while significantly improving patients' quality of life—an especially critical consideration for early DKD intervention. Current research focuses on merging TCM's holistic approach with modern medicine's precision in targeting signaling pathways for DKD therapy. Notably, terpenoids, flavonoids, phenolic compounds, alkaloids, and TCM formulations (e.g., Shuilu Dihuang Capsule, Angelica Sinensis Blood Tonic Soup, Tangshen Ning Formula, Jinlida Granule, and Torch Root Tablets) have exhibited significant targeting effects on AMPK. This review comprehensively synthesizes recent domestic and international advancements in TCM-mediated regulation of the AMPK signaling pathway in DKD.