Abstract: Diabetic nephropathy is one of the microvascular complications of diabetes mellitus. Its pathogenesis is complex and crosslinked with factors including glucolipid metabolism disorders, inflammation, oxidative stress, impaired autophagy, and intestinal flora imbalance. It is also the main cause of end-stage renal disease. This article has reviewed the main pathogenesis of diabetic nephropathy and the research progress of berberine in the prophylactic treatment of diabetic nephropathy, aiming to provide references for the development of drugs for the treatment of diabetic nephropathy.