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Their potential as liquid biopsy biomarkers and engineered therapeutic carriers\u2014delivering nucleic acids, proteins, or stem cell-derived regenerative signals\u2014offers promising avenues for diabetes management. However, there are some critical challenges in clinical translation. Future research must prioritize (1) scalable GMP-compliant production with rigorous quality control, (2) targeted delivery systems via ligand modification or biomimetic engineering, (3) improved biocompatibility through cargo optimization and stealth coatings, and (4) large-scale clinical trials to validate efficacy and safety. 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