The COVID-19 pandemic may have profound implications for pediatric type 1 diabetes (T1D), influencing disease incidence, presentation, management, and outcomes. Emerging evidence suggests a possible increase in new-onset T1D during the pandemic, potentially due to direct or indirect effects of SARS-CoV-2 infection, though causality remains inconclusive. Mechanistic studies indicate that viral entry factors such as ACE2 and TMPRSS2 are variably expressed in pancreatic tissue, and COVID-19-associated immune dysregulation may contribute to beta-cell injury in genetically susceptible individuals. Clinical data shows that children with T1D generally experience mild COVID-19 infections, though poor glycemic control increases risk for complications such as diabetic ketoacidosis (DKA). The pandemic disrupted healthcare delivery, prompting rapid adoption of telemedicine and highlighting disparities in care access, particularly among socioeconomically disadvantaged families. COVID-19 vaccination is recommended for children with T1D and may confer protective effects against virus-associated metabolic complications. Global epidemiological and mechanistic research is needed to clarify the relationship between SARS-CoV-2 and T1D pathogenesis, optimize pediatric diabetes care in pandemic conditions, and prepare for future public health crises.