Under the guidance of the "Health China 2030 Plan", effective intervention in the pre-diabetic stage is the key to prevent and delay the development of diabetes mellitus. In this study, the characteristics of the intestinal microenvironment in the pre-diabetic population and the possible pathogenic mechanisms of intestinal flora disorders in people with impaired glucose regulation are summarized. The development of diabetes mellitus is related to the number of flora and altered intestinal permeability. The theory of spleen-warm syndrome in Chinese medicine provides a theoretical basis for intervention in pre-diabetes mellitus and summarizes the current research progress of Chinese herbal medicine in the catalogue of medicine and food sources in intervening in pre-diabetes mellitus by regulating the intestinal microenvironment, providing an evidence-based basis and therapeutic targets for delaying the progression of diabetes mellitus.