Diabetes mellitus complicated with pregnancy (PGDM) is one of the important complications in pregnancy, and its hyperglycemia significantly increases the risk of adverse outcomes of mother and fetus. According to the data of the International Diabetes Federation, as the country with the largest number of diabetic patients, the pre-pregnancy awareness rate of PGDM pregnant women is only 1.2%, far below the global average. This paper systematically reviewed the status quo and influencing factors of PGDM's pre-pregnancy awareness and its influence on perinatal management and maternal and fetal outcomes, with in-depth analysis of international advanced experiences and management strategies. It is found that improving the awareness rate of diabetes before pregnancy is helpful to realize early intervention and individualized management, and significantly improve the prognosis of mother and fetus. Based on evidence-based findings, this review proposes specific strategies including three-tier prevention system construction, information-based management platform development, and health education model innovation. Therefore, we should strengthen the pre-pregnancy screening, build a multidisciplinary cooperation model, and improve the outpatient service construction of diabetic pregnant women, so as to provide theoretical basis and practical guidance for reducing PGDM-related adverse outcomes