Background <p>Diabetes mellitus is a chronic metabolic disorder that results from insulin deficiency or abnormality, leading to significant disruptions in glucose, fat, and protein metabolism. One of the most feared complications is diabetic foot ulcers (DFUs), which affect 15 to 25% of diabetic patients and are a leading cause of nontraumatic lower-limb amputations.</p> Objective <p>This systematic review and meta-analysis was aimed at evaluating the prevalence and associated risk factors of fungal infections in DFUs.</p> Methods <p>PubMed (Medline), Scopus, Web of Science, and ProQuest were searched for English articles up to 19/02/2025. A total of 2145 articles were found and screened, from which 25 articles were selected, reviewed and analyzed.</p> Results <p>The meta-analysis revealed a pooled prevalence of fungal DFUs of 0.19 (<i>p</i>-value &lt; 0.001). Gender-specific analysis indicated that men had a significantly higher prevalence (0.62) compared to women (0.35). Furthermore, patients with type 2 diabetes exhibited a higher prevalence of ulcers (0.67) compared to those with type 1 diabetes (0.30). Funnel plot evaluation showed some asymmetry, suggesting potential publication bias, while Egger’s test was limited in power due to the small number of studies. Substantial heterogeneity (<i>I</i>² &gt; 50%) was observed among studies.</p> Conclusion <p>These findings highlight the critical role of fungal infections, particularly those caused by <i>Candida</i> species, in the development and exacerbation of DFUs. Increased awareness and targeted preventive measures are essential to improve patients’ outcomes and mitigate the negative impact of this serious complication on public health.</p>