Diabetes is known to affect metabolic, vascular, and nervous systems, although its influence on auditory function in children remains poorly defined. Understanding this association is essential due to its implications for cognitive, language, and social development. Numerous studies have found that children with Type 1 Diabetes Mellitus (T1DM) exhibit higher hearing thresholds at high frequencies (4000–8000 Hz) and lower speech understanding scores compared to healthy controls. Poor glycemic control and longer disease duration are consistently associated with worse auditory outcomes. The proposed mechanisms include microangiopathy and diabetic neuropathy affecting the auditory pathway. Many affected children do not report noticeable auditory symptoms, indicating a risk of underdiagnosis. Early identification is crucial, as hearing difficulties in children may be related to underlying diabetic conditions and are likely associated with poor glycemic control. Regular audiometric screening should be incorporated into the routine care of pediatric diabetes patients to identify hearing deficits before they affect communication and cognitive development.