Abstract: Diabetic nephropathy(DN), as a primary cause of end-stage renal disease, poses a serious threat to public health. However, the competitive endogenous RNA(ceRNA) network mediated by non-coding RNA(ncRNA) regulates key biological processes, including inflammation, apoptosis, fibrosis, oxidative stress, endoplasmic reticulum stress, and autophagy. By modulating the functions of podocytes, mesangial cells, and renal tubular epithelial cells, it forms a multilayered regulatory network and consequently plays a pivotal role in the progression of DN. In addition, the exosome ceRNA network, biomolecules, and traditional Chinese medicine-targeted regulation of the ceRNA network are becoming increasingly important in the progression of DN. Based on this, this review summarises the research progress on ceRNA regulatory networks, regulatory pathways and target tissues of DN, exosome-derived ceRNA regulatory networks, and targeted regulation of ceRNA networks in DN. Furthermore, it discusses current bottlenecks in ceRNA network research, challenges in targeted therapy, and pharmacokinetic deficiencies in traditional Chinese medicine interventions targeting ceRNA networks, which aims to offer novel perspectives for further exploration of DN’s molecular mechanisms and drug development.