Food processing techniques are widely used in the food industry to ensure food safety, extend shelf life, and enhance sensory appeal without compromising the product’s nutritional quality. Pearl millet, which is considered a “nutricereal”, features essential content of proteins, soluble and insoluble fibers, minerals (e.g., iron, zinc, and magnesium), bioactive compounds (e.g., phenolic acids, flavonoids, and carotenoids), and antinutritional factors (e.g., phytic acid, C-glycosyl flavones, tannins, and non-digestible oligosaccharides). This nutricereal also undergoes processing methods to improve or maintain its nutritional quality while simultaneously reducing antinutritional factors. Pearl millet processing techniques are categorized into conventional (or traditional) and advanced methods; however, a knowledge gap exists in studies evaluating the post-processing of pearl millet and its impact on metabolic health in in vivo and in vitro experimental models. This study aims to demonstrate the principal conventional and advanced processing techniques used in pearl millet, how they can ensure nutritional quality and reduce antinutritional factors, and how the final post-processing product could impact metabolic health.