Abstract: It's widely recognized that genetic and environmental factors are significant to the development and progression of type 2 diabetes mellitus (T2DM). The basic function of transfer RNAs (tRNAs) is to participate in protein translation and accurately translate the genetic information carried by messenger RNA (mRNA) into amino acid sequence. However, recent studies have shown that tRNA-associated dysregulation is related to T2DM and plays a crucial role in the pathogenesis of T2DM. This paper reviewed the research progress of tRNA-associated dysregulation in T2DM including tRNA mutations, tRNA modifications and tRNA aminoacylation, aiming at a better understanding of the pathogenesis of T2DM and providing new ideas for the personalized treatment of this metabolism-associated disease.