Diabetes mellitus can result in many ocular complications, such as retinopathy, optic neuropathy, neovascular glaucoma and metabolic cataract, and plays an important role in causing blindness. In addition to diabetic retinopathy, the incidence of diabetic ocular surface diseases is also increased. Diabetes can lead to changes in the ocular surface including the lacrimal glands, tarsal glands, conjunctiva, tear film and cornea, such as dry eye, meibomian gland dysfunction, and corneal epithelial damage. This article reviews the research progress of ocular surface lesions and the pathogenesis in type 2 diabetes mellitus, hoping to provide theoretical basis for its clinical diagnosis and treatment.