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Under physiological conditions, coordinated interactions among immune, stromal, vascular and neural cells ensure timely initiation and resolution of inflammation, thereby maintaining osteoimmune homeostasis and supporting bone repair. In diabetes, hyperglycemia-induced oxidative stress, advanced glycation end products, impaired vascularization and \u2018inflammatory memory\u2019 prolong and intensify inflammatory responses. This excessive and unresolved inflammation disturbs immune\u2013bone crosstalk, alters macrophage and T-cell phenotypes and uncouples osteogenesis and angiogenesis, ultimately hindering bone regeneration. This review summarizes the cellular and molecular basis of osteoimmune homeostasis and outlines how diabetes disrupts this regulatory network at systemic and local levels. We further highlight biomaterial strategies designed to modulate excessive inflammation and restore osteoimmune balance in diabetic bone regeneration, including localized delivery systems, cell-derived and extracellular vesicle-based agents, nanozyme-mediated microenvironmental regulation and immune-instructive physicochemical biomaterials. Finally, we discuss the critical hurdles of clinical translation (e.g. standardized scalable fabrication and long-term biosafety) and highlight multifactor integrated, logic-gated designs and systemic diabetes management strategies for advancing next-generation biomaterials for diabetic bone regeneration.<\/jats:p>","DOI":"10.1093\/rb\/rbag055","type":"journal-article","created":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T12:24:20Z","timestamp":1773059060000},"source":"Crossref","is-referenced-by-count":1,"title":["Biomaterial regulation of excessive inflammation restores osteoimmune homeostasis in diabetic bone regeneration"],"prefix":"10.1093","volume":"13","author":[{"given":"Qiyue","family":"Zhou","sequence":"first","affiliation":[{"name":"Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Institute of Stomatology, Nanjing University , Nanjing, Jiangsu 210008,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8681-3867","authenticated-orcid":false,"given":"Yu","family":"Zhang","sequence":"additional","affiliation":[{"name":"Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Institute of Stomatology, Nanjing University , Nanjing, Jiangsu 210008,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhuo","family":"Dai","sequence":"additional","affiliation":[{"name":"Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Institute of Stomatology, Nanjing University , Nanjing, Jiangsu 210008,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9086-8502","authenticated-orcid":false,"given":"Qiang","family":"Li","sequence":"additional","affiliation":[{"name":"Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Institute of Stomatology, Nanjing University , Nanjing, Jiangsu 210008,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8118-7975","authenticated-orcid":false,"given":"Weijun","family":"Xiu","sequence":"additional","affiliation":[{"name":"Institute for Health Innovation and Technology, Biomedical Engineering Department, National University of Singapore , Singapore 119276,","place":["Singapore"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haoxin","family":"Lv","sequence":"additional","affiliation":[{"name":"Department of Oral Implantology, Suzhou doctor dental clinic Co. 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