Fenugreek (Trigonella foenum-graecum) is a medicinal plant with notable antidiabetic and lipid-lowering properties. Rich in soluble fibers, amino acids, vitamins, and saponins, fenugreek seeds have demonstrated significant efficacy in managing type II diabetes mellitus (T2DM) and associated dyslipidemia. This review synthesizes recent research from 2019 to 2024, highlighting clinical trials and interventional studies. Fenugreek supplementation significantly reduces fasting blood glucose, HbA1c, and improves serum insulin levels, thereby delaying the progression of prediabetes to T2DM. Additionally, fenugreek enhances lipid profiles by lowering triglycerides and LDL cholesterol while increasing HDL cholesterol. These effects are primarily due to fenugreek’s high fiber content, which slows carbohydrate absorption and metabolism, and bioactive compounds that stimulate insulin secretion and improve insulin sensitivity. The findings suggest fenugreek as a cost-effective, low-toxicity dietary intervention for managing diabetes and dyslipidemia. Further large-scale clinical trials are recommended to confirm these benefits and explore long-term outcomes.