ObjectiveTo systematic review the prevalence and influencing factors of diabetes among children and adolescents in China from 2000 to 2025. MethodsThe Web of Science, PubMed, EBSCO, CNKI, WanFang Data and VIP databases were electronically searched to collect studies on the prevalence rate and risk factors of diabetes from inception to January 2025. Two reviewers independently screened the literature, extracted data, and assessed the risk of bias of the included studies. Meta-analysis was then performed using Stata 18.0 software. ResultsA total of 18 studies were included, involving 25 754 697 study subjects, including 1 456 children with diabetes. The prevalence of diabetes among Chinese children and adolescents was 1.6‰ (95%CI 1.2‰ to 2.2‰). Subgroup analysis showed that the prevalence was 2.8‰ (95%CI 1‰ to 5.3‰) in males, 1.0‰ (95%CI 0‰ to 4.1‰) in the senior high school stage, 3.1‰ (95%CI 2.5‰ to 3.8‰) in urban areas, 1.9‰ (95%CI 0‰ to 8.4‰) for those diagnosed using the WHO diagnostic criteria, and 1.6‰ (95%CI 0.3‰ to 3.8‰) for type 2 diabetes. Time trend analysis showed that the prevalence rate overall exhibited a fluctuating upward trend. ConclusionThe prevalence of diabetes among children and adolescents in China is high, and heredity, obesity and lifestyle are the main influencing factors. It is necessary to develop differentiated prevention and control strategies for high-risk groups, and standardize diagnostic standards to improve the accuracy of monitoring.