Diabetes mellitus with three more and one less symptom is generally not caused by spleen and stomach deficiency, but may be related to qi deficiency. Diabetes mellitus belongs to the category of Chinese medicine “thirst” syndrome, the “three more and one less” symptoms of thirst, namely, polyuria, polydipsia, polyphagia, weight loss, and diabetes mellitus in Western medicine are basically the same. The etiology of the disease may be related to insufficient endowment (innate constitution and poor function), dietary disorders, emotional disorders, excessive labor and other factors. The main lesions of the internal organs lie in the lungs, kidneys and stomach, i.e., lung dryness, gastric heat, kidney deficiency, and generally have no direct relationship with spleen and stomach deficiency. According to the different symptom manifestations, it is categorized into upper elimination type (lung-heat and fluid-injury syndrome), middle elimination type (stomach-heat blazing syndrome), and lower elimination type (kidney-yin deficiency syndrome). Among them, Lung Heat and Fluid Injury (heat evil in the lungs that continuously depletes the body’s fluids) syndrome is characterized by irritable thirst and excessive drinking and urination, Stomach Heat and Blazing Syndrome is mainly characterized by polyphagia, thirst, excessive urination, excessive drinking, and emaciation, while Kidney Yin Deficiency can also be characterized by polyphagia, sweet urination, fatigue, thirst, and other symptoms. The basic pathogenesis of the thirst syndrome for the Yin deficiency for this, dry heat for the standard, and Qi deficiency can lead to the degradation of the function of the internal organs, thus showing a series of signs of weakness of the internal organs, equivalent to the modern medical opinion of diabetes mellitus. It is recommended that patients with symptoms such as excessive drinking, excessive eating, excessive urination, weight loss, etc., promptly go to a formal Chinese medicine hospital, under the guidance of the Chinese medicine practitioner’s diagnosis and treatment.