Momordica charantia (MC), commonly known as bitter melon, has garnered attention for its diverse pharmacological properties, particularly its potential in managing diabetes mellitus (DM) and associated complications. The present narrative review comprehensively assesses the scientific landscape surrounding MC's efficacy and safety in the context of diabetes and its related complications, encompassing neuropathy, nephropathy, impaired wound healing, retinopathy, dyslipidemia, fatty liver disease, hypertension, and atherosclerosis. Drawing insights from both experimental studies on animal models and clinical trials, the present evaluation reveals that MC exhibits notable hypoglycemic effects attributed to its rich phytochemistry, including bioactive components such as charatin, vicine, and various momordin compounds. Moreover, the herb demonstrates antioxidant, anti-inflammatory, and immunomodulatory properties, offering potential benefits in mitigating complications associated with DM. However, while animal model studies showcase promising results, clinical evidence remains somewhat inconclusive, necessitating further rigorous investigation. Nevertheless, in the context of diabetes’s incurable nature, MC emerges as a promising supplementary approach for diabetes management, showcasing mild outcomes with sustained efficacy and exhibiting a favorable safety profile.