Diabetes mellitus, a ubiquitous metabolic disorder, is characterized by perturbations in glucose homeostasis, posing significant challenges to both patients and healthcare practitioners. This article endeavors to provide an in-depth analysis of the etiological underpinnings, classifications, and medical management strategies associated with diabetes mellitus. Fellowship in Diabetes Mellitus comprises of : I. Etiological Determinants 1. Genetic Predisposition: A hereditary proclivity remains a significant contributory factor in the genesis of diabetes, underlining the importance of family history assessments. 2. Insulin Resistance: Type 2 diabetes mellitus primarily emanates from the presence of insulin resistance, whereby peripheral tissues exhibit diminished responsiveness to insulin's metabolic signaling. 3. Autoimmune Pathogenesis: Type 1 diabetes ensues due to an autoimmune phenomenon resulting in the selective destruction of pancreatic beta cells, culminating in absolute insulin deficiency. 4. Lifestyle Factors: The precipitating role of sedentary lifestyles, obesity, and suboptimal dietary choices cannot be understated in the pathogenesis of type 2 diabetes.