Abstract: Diabetes is a chronic disease caused by metabolic disorders due to abnormal blood glucose levels, and insulin is a commonly used drug in the treatment of diabetes. Different types of insulin exhibit different clinical efficacy due to their mechanisms and duration of action in the body, the basal long-acting release and postprandial controlled release of insulin have always been hot topics among clinical researchers. With the development of nanotechnology, the research and development of new nano-drug carriers with excellent drug release properties have become an important opportunity to solve clinical targeted medication, especially the loading of insulin by metal-based nanocarriers is expected to be an effective path to enhance the therapeutic efficacy in clinical diabetic patients. Herein, around the controllable release of insulin, the basic categories and characteristics of clinical insulin are briefly introduced, and the synthesis of metal-based nanocarriers and their drug release performance for insulin are emphasized. The performance of gold-based, iron-based, copper-based, and zinc-based metal-based nanocarriers in insulin loading are analyzed, the characteristics of different metal-based nanocarriers in insulin loading are introduced through specific comparative parameter, the mechanism and typical features of insulin loading elaborated by metal-based nanocarriers, and the influencing factors of carrier size, carrier morphology, and surface functionalization on the insulin release from carriers are also discussed. Finally, reflects on existing issues and provides insights into future directions, aiming to offer technical references and new ideas for the treatment of clinical diabetes.