Abstract:Diabetic osteoporosis (DOP) is the most common chronic complication of diabetes in the skeletal system. DOP is often insidious in onset, with atypical symptoms, which makes it easy to be overlooked in the early stages. Its disability and mortality rates are relatively high. Studies have shown that the OPG-RANKL-RANK axis is a key factor in regulating osteoclast differentiation, maturation, and bone resorption. This axis can modulate bone metabolism by mediating various signaling pathways, including the P38 MAPK signaling pathway, which regulates osteoclastogenesis and differentiation. Therefore, further exploration of the relationship between the OPG-RANKL-RANK axis and the P38 MAPK signaling pathway could provide new insights for the prevention and treatment of DOP. This review summarizes the mechanisms through which the OPG-RANKL-RANK axis mediates the P38 MAPK signaling pathway to regulate osteoclasts in DOP, offering new research directions for clinical treatment.