Diabetes mellitus is a common and important metabolic disorder， and as of 2024， the global diabetic population has reached approximately 589 million， thus constituting a major public health challenge worldwide. Hyperglycemia promotes microangiopathy， nerve injury， and immune dysregulation， all of which impair wound healing and significantly increase the risk of infection and disability in diabetic patients. However， the mechanisms underlying the initiation and progression of impaired diabetic wound healing remain complex and not fully elucidated. Pigment epithelium-derived factor （PEDF） is a multifunctional endogenous glycoprotein that participates in angiogenesis regulation， cell proliferation and differentiation， oxidative stress modulation， and tissue remodeling. Its expression during normal wound healing is stage-specific and functionally important at each phase of the repair process. In sharp contrast， dysregulated PEDF is now widely regarded as a central molecular mechanism underlying impaired healing in diabetic wounds. This review systematically examines the mechanistic role of PEDF in diabetic wound healing and discusses PEDF-targeted interventions and their clinical prospects， aiming to provide a novel theoretical basis and concrete molecular strategies for the precise treatment of chronic diabetic wounds.