Background <p>Continuous glucose monitoring (CGM) may facilitate behavior modifications among individuals with diabetes. However, existing evidence regarding its effectiveness remains inconsistent. This study aimed to evaluate the effectiveness of CGM in improving physical activity and diet for people with diabetes using both qualitative and quantitative approaches.</p> Methods <p>We searched PubMed, Cochrane, Embase, and Web of Science on October 13, 2024 to identify studies utilizing CGM in people of any age with any type of diabetes that reported outcomes related to physical activity and/or diet and were eligible for systematic review. Randomized controlled trials in which CGM was used as the main intervention and whose outcomes could be quantitatively synthesized were included in the meta-analysis.</p> Results <p>The initial search identified 13,128 records, then 28 studies met the inclusion criteria for the systematic review. Of these, 10 and 8 studies were included in the meta-analysis of physical activity and diet, respectively. Compared with controls, CGM significantly increased daily physical activity time (MD: 16.21&#xa0;min/day, 95% CI: 10.26 to 22.16; <i>P</i>&lt;0.0001) (low-certainty evidence). In addition, CGM significantly reduced daily caloric intake (-70.81&#xa0;kcal/day, -132.93 to -8.69; <i>P</i> = 0.03) (low-certainty evidence) and carbohydrate consumption (-19.88&#xa0;g/day, -27.74 to -12.01; <i>P</i> &lt; 0.00001) (low-certainty evidence) versus controls.</p> Conclusions <p>CGM significantly increased daily physical activity time and reduced both caloric intake and carbohydrate consumption in adults with diabetes. Future high-quality, large-scale randomized controlled trials are warranted to confirm these associations and to clarify the mechanisms underlying CGM’s behavioral effects across diverse diabetes populations.</p> Trial registration <p>International Prospective Register of Systematic Reviews (PROSPERO; CRD42024609764).</p>