Undoubtedly, Nigeria is the most populous country in Africa with about 400 ethnic groups and languages. There is a double burden of disease with rising incidence and prevalence of diabetes mellitus. World Health statistics indicate that Nigeria has the highest number of diabetics in sub-Saharan Africa. In spite of advances in diabetes care and facilities, desired outcomes are not good and linked to this, patient satisfaction is not optimal. Reasons include inadequate attention to biological aspects of diabetes, inadequate or inappropriate pharmacology and psycho-socio-cultural factors. In this review, crucial socio-cultural factors in Nigeria include traditional medicine, religion, diet, physical activity patterns, foot care, awareness, and stress management. Diabetes programs in Nigeria should adopt the principles of education and psycho-social support highlighted by the DAWN study, integrating our socio-cultural heritage, empowering individuals to take charge of their diabetes and achieve desired health outcomes. Religion should be explored as a potential tool to reach out on facts whilst doing away with erroneous beliefs about diabetes mellitus.