We conducted a systematic review of the construction method and pathological mechanisms of animal and cellular models for diminished ovarian reserve (DOR), to provide a theoretical basis for understanding its pathophysiological mechanisms and references for future drug development and therapeutic strategies. We carried out extensive retrieval and analysis of the recent literature to identify the detailed diverse modeling approaches (including pharmaceutical induction, environmental factors, natural factors, and composite factors) and explored the roles of their mechanisms in DOR pathogenesis. The pathogenesis of DOR involves multiple factors, including oxidative stress, apoptosis and autophagy dysregulation, impaired angiogenesis, and imbalances in follicular development and the immune microenvironment. Studies also revealed intrinsic correlations among key signaling pathways in DOR models. Although existing DOR modeling method can effectively replicate Western medicine pathological features,models incorporating traditional Chinese medicine (TCM) syndrome characteristics remain scarce. Given the unique advantages of TCM in regulating the complex pathological network of DOR, future research is needed to prioritize the construction of TCM syndrome-oriented DOR models. This will support investigations into the scientific basis of TCM’s multi-target regulatory mechanisms and provide a robust theoretical foundation for clinical applications.