The global incidence of diabetes mellitus has recently shown a steep rise. Diabetic kidney disease (DKD), as one of the most prevalent microvascular complications, has accordingly become the primary cause of endstage renal disease. There is an urgent need to identify safe, reliable, cost-effective, and low-side-effect medications for early interventions for DKD to delay disease progression. Pathological studies have revealed that the adenylate monophosphate-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. Traditional Chinese medicine (TCM) has been shown to effectively alleviate edema, proteinuria, and declining renal function, while significantly improving patients’ quality of life—a critical consideration for early DKD intervention. Notably, terpenoids, flavonoids, phenolic compounds, alkaloids, and several TCM formulations ( e. g. , Shuilu Dihuang capsules, Angelica Sinensis Blood Tonic soup,Tangshenning formula, Jinlida granules, and Colquhounia Root tablets) have exhibited significant AMPK pathwaytargeting effects. This review comprehensively synthesizes recent domestic and international advancements in TCMmediated regulation of the AMPK signaling pathway in DKD, aiming to provide a reference for understanding the mechanisms and clinical efficacy of TCM in treating DKD.