Bidens pilosa L. is an easy-to-grow, widespread, and palatable perennial on earth. Hence, it has traditionally been used as foods and medicines without noticeable adverse effects. Despite significant advancement in chemical and biological studies of B. pilosa over the past few years, comprehensive and critical reviews on its anti-diabetic properties are missing. The present review is to summarize up-to-date information on the pharmacology, phytochemistry, and toxicology of B. pilosa, in regard to type 1 diabetes and type 2 diabetes from the literature. In addition to botanical studies and records of the traditional use of B. pilosa in diabetes, scientific studies investigating antidiabetic action of this species and its active phytochemicals are presented and discussed. The structure and biosynthesis of B. pilosa and its polyynes in relation to their anti-diabetic action and mechanism are emphasized. Although some progress has been made, rigorous efforts are further required to unlock the molecular basis and structure-activity relationship of the polyynes isolated from B. pilosa before their clinical applications. The present review provides preliminary information and gives guidance for further anti-diabetic research and development of this plant.