<p>Diabetic neuropathy (DN) is a common and debilitating complication of diabetes mellitus, often presenting with chronic pain and sensory or motor deficits. Current treatment options provide only partial symptomatic relief and are frequently associated with adverse effects, underscoring the need for more effective and targeted approaches. Microneedle (MN) technology has emerged as a minimally invasive, highly efficient, transdermal-delivery strategy offering increased drug absorption, sustained drug release, and patient compliance. Different designs of MN, such as solid, coated, dissolving, and hydrogel-based, are available and provide specific strategies in DN management. The patient-specific and solid microneedles, like the lipid-cast microneedles functionalized with the lidocaine and dexamethasone, have demonstrated the possibility to provide long-term pain relief. Emulsion formulations of microneedles made of hydrogel loaded with nerve growth factor show potential in enhancing nerve repair. Biodegradable polymers such as polyvinyl alcohol (PVA) and polyvinylpyrrolidone (PVP) can be dosed well. Still, more advanced materials, such as polylactide (PLA) and polycaprolactone (PCL), need to be engineered for scalable and cost-efficient production. It has its main obstacles that include drug stability and production, mass culturing, and complicated regulatory processes. The combination of MN platforms, nanomedicine and advanced delivery systems could provide synergistic therapeutic effects that could be the next step towards personalised, effective, and endurable DN treatment. This review identifies new developments, limitations, and areas to explore in terms of using microneedle technology as a method of targeted drug delivery for diabetic neuropathy.</p> Graphical abstract <p></p>