Every diabetic patient asks: How did diabetes really come about? Along with the development of medicine, more and more drugs are available to treat diabetes, and technology is constantly innovating, yet instead of being controlled, the incidence of diabetes is rising year by year. Why is this? Many patients have shared the fruits of medical research regarding the doctrine of diabetes onset. Diabetes is a group of metabolic syndromes that are the result of the action of genetic factors and various environmental factors, and are related to various factors such as insulin resistance, absolute or relative deficiency of insulin secretion, and immune response. However, the knowledge we have gained from traditional diabetes education does not provide a profound explanation for the explosive epidemic of diabetes in the era in which we live today. There used to be a saying that diabetes is a disease of civilization. What if someone told you that diabetes is a side effect of the rapid pace of human civilization, a misalignment between the evolution of human genes and the development of civilization in terms of speed. How would you feel about that somewhat negative-sounding conclusion, and how should you look at the way we live today? For many of the health issues facing us today, there may be some useful insights if the problem is understood in the context of natural human evolution. Disease should be treated to a large extent as a consequence of the ecological evolutionary process. Some diseases or symptoms arise and even protect us from survival. For example, we commonly have fever, which is one of the mechanisms by which the body fights infection. Sickle cell anemia, which is a common genetic disease among African and American blacks, and did you know that the gene that causes sickle cell anemia can fight malaria? Also, gout is an unintended consequence of human efforts to gain longevity, schizophrenia susceptibility genes facilitate increased human creativity, and so on. This is despite the fact that some medical doctors are not used to functional hypotheses because they are indoctrinated to believe only the experimental scientific conclusions advocated by Bacon. However, some disease concepts established from a biological evolutionary perspective, although not subjected to classical scientific experiments, have explained or predicted many of the problems of some diseases like diabetes. In the Stone Age, it was not an easy task to obtain a sweet fruit, and sugar and salt have been something lacking for the vast majority of human life. Perhaps it was the sweetness but not the availability that developed a taste for sweet things in the course of biological evolution. And today sugar and salt are abundantly available on our tables and in our snacks at our fingertips. The consequence of this is not only the prevalence of dental caries (which was rare before industrialization), but also many health problems, such as diabetes and hypertension. The diseases of modern civilization have a common lifestyle basis. Not only sugar and salt, but in the early evolution of mankind, due to low productivity and chronic poverty, a gene was gradually acquired by natural selection in order to adapt to the hunter-gatherer mode of life. The function of this gene is to store the energy taken from food in order to prepare for starvation, so it has been imaginatively called the “conservation gene”. In today’s human race, the percentage of conservation genes is still high because evolution takes time, and time that is counted in millennia. However, our productivity and civilization have changed seemingly overnight, and the speed of development has not left enough time for genes to adapt to it. As a result, in the face of the rich material and spiritual life, the function of the “conservation gene” conflicts with the “superior” life, and instead of helping to convert energy, the conservation gene turns it into excess fat, causing obesity, insulin resistance, diabetes, etc. This causes obesity, insulin resistance, diabetes, etc. Humans have always lived in a paradox of malnutrition and overnutrition. Before Neil, a geneticist at the University of Michigan, proposed the theory of “saving genes” in 1962, a thought-provoking event occurred. The Pimai Indians of Arizona, who had been suffering from malnutrition for a long time, took action to change their nutritional status and were provided with a large amount of subsistence food. However, an unexpected thing happened, obese people and diabetics greatly increased. In the following decades, countries and regions of the world that became rapidly rich, such as the United States, Nauru, Singapore, India, China, etc., were to go through a phase of high diabetes prevalence. These facts are a constant reminder that nutritional issues are not determined by our tastebuds. What tastes good is often not good for the body. The roots of today’s diabetes epidemic were planted deep in the Stone Age. The “conservation gene” expresses an evolutionary principle that goes beyond medicine and philosophy, and it is thus predictable that one hypothesis is contrary to the ideals of the people. That is: the high prevalence of diabetes is likely to continue for a considerable period of time. This somewhat pessimistic argument does not mean that we should just sit back and wait for diabetes to die. On the contrary, understanding the true nature of diabetes is a way to better adapt our research strategies and our lifestyles. Although we cannot revert back to the primitive at the expense of today’s civilization, we should pay attention to our evolutionary roots while pursuing the enjoyment of life. Nothing could be more important to a diabetic than eating; nothing could be more important than preventing its occurrence.