Tehran University of Medical Sciences Iranian Journal of Allergy, Asthma and Immunology 1735-1502 25 1 2026 01 01 1 15 Mehrangiz Ghafari Department of Pathology, School of Medicine, Zabol University of Medical Sciences, Zabol, Iran Javad Poursamimi Department of Immunology, Faculty of Medicine, Zabol University of Medical Sciences, Zabol, Iran. Foroogh Asli Department of Internal Medicine, School of Medicine, Zabol University of Medical Sciences, Zabol, Iran 2025 05 06 2025 07 25 Metformin is a primary treatment for type 2 diabetes (T2D), well-known for its ability to lower blood glucose levels through both AMP-activated protein kinase (AMPK)-dependent and -independent pathways. Recent evidence suggests that metformin also possesses immunomodulatory properties, indicating its potential as a therapeutic agent that extends beyond metabolic regulation. This review summarizes the current understanding of metformin's dual roles in managing diabetes and modulating the immune system. It also explores the underlying mechanisms, clinical implications, and potential directions for future research. https://ijaai.tums.ac.ir/index.php/ijaai/article/view/4434 https://ijaai.tums.ac.ir/index.php/ijaai/article/download/4434/2253