Diabetes is a major Public health issue all over the world. Diabetes affects approximately 463 million adults worldwide, with a prevalence of 9.3%. As a result of increased obesity, sedentary lifestyle, and an ageing population, the prevalence is expected to rise to 10.9% (700 million adults) by 2045. T2D accounts for roughly 90% of all diabetes cases globally. With approximately 150 million Muslims worldwide living with diabetes, the prevalence of type 2 diabetes (T2D) is increasing in most countries and even higher in several large Muslim-majority countries (including Indonesia, Egypt, and Bangladesh). Fasting during the holy month of Ramadan, one of Islam's five pillars, is a requirement for all healthy adult Muslims. Muslims are not permitted to eat, drink, or engage in sexual activities. As a result, Ramadan has a significant impact on diabetes management in the Muslim population. Although people with diabetes are exempt from Ramadan fasting, many of them do. A large population-based study conducted in 13 countries found that approximately 79% of Muslims with T2D fast during Ramadan, highlighting the critical need to understand the implications of Ramadan fasting for people with diabetes. Medical nutrition therapy (MNT) is an important part of diabetes management, and it is especially important during Ramadan fasting. During Ramadan fasting, patients may consume meals at night, with two main meals known as Suhoor (served before dawn) and Iftar (served after sunset) (served after sunset). Thus, when compared to other times of the year, Ramadan causes a significant change in dietary and lifestyle patterns, as well as changes in physiological processes. Insulin resistance or deficiency during prolonged fasting causes excessive glycogen breakdown, which leads to increased Gluconeogenesis and ketogenesis, resulting in hyperglycemia and ketoacidosis. Furthermore, long periods of abstaining from foods during the day may lead to overeating with inappropriate food choices at night, which typically consist of large amounts of carbohydrates and sugary drinks. Despite the fact that professional diabetes guidelines emphasise the importance of MNT during Ramadan, determining the best nutritional strategy for Ramadan fasting remains difficult due to cultural and regional differences. The majority of previous reviews on Ramadan fasting in diabetes focused on the safety of Ramadan fasting, the role of drug therapy in diabetes management, other medical treatments, health outcomes, or the impact of Ramadan-focused education, with limited content on nutrition therapy. Gad et al. discovered that Ramadan-focused education improved glycemic control and LDL-cholesterol levels while increasing weight and triglycerides levels with no data reporting on dietary intake outcomes, the effects of Ramadan-focused nutrition therapy for people with diabetes. We investigate the key aspects of the nutrition therapy component that may result in favourable clinical outcomes. The findings will assist Healthcare professionals in determining the most effective nutritional approach for individuals with T2D who wish to fast during Ramadan.