We aimed to evaluate the efficacy of aloe vera on serum lipid profiles and glycemic markers in the management of Metabolic Syndrome (MetS). A systematic search was conducted across electronic databases, including the Cochrane Central Register of Controlled Trials, EBSCOhost, MEDLINE, and CINAHL. Randomised controlled trials (RCTs) that investigated the effects of aloe vera on total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglyceride (TG), fasting blood glucose (FBG) and glycated haemoglobin (HbA1c) were included in our analysis. We pooled the data and analysed it using a random-effects model and assessed the certainty of evidence using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Our meta-analysis showed no significant reductions in TC (mean difference [MD] = −0.04 mmol/L; 95% CI: −0.34 to 0.26) and LDL-C (MD = −0.01 mmol/L; 95% CI: −0.17 to 0.14). However, there was a significant increase in HDL-C (MD = 0.05 mmol/L; 95% CI −0.00 to 0.09) and a substantial reduction in TG (MD = −0.34 mmol/L; 95% CI −0.45 to −0.22), FBG (MD = −1.41 mmol/L; 95% CI −1.98 to −0.84) and HbA1c (MD = −0.51%; 95% CI −0.72 to −0.31) following aloe vera consumption. While Aloe vera showed a marginal increase in HDL-C and reductions in TG, FBG, and HbA1c, the overall quality of evidence is mostly very low.