Autoimmue diabetes is characterized by the damages in pancreatic β cells mediated by T cells and the presence of islet autoantibodies in the circulation. The initiation of autoimmune is the key step in its pathogenesis. Autoantibodies are the most reliable biomarkers for type 1 diabetes mellitus (T1DM), and widely used in clinical practice, especially in the prediction and diagnosis of T1DM. Though islet related autoantibodies are diverse with various features, glutamic acid decarboxylase antibodies (GADA), insulin autoantibodies (IAA), insulinoma-associated protein 2 antibodies (IA-2A) and zinc transporter-8 antibodies (ZnT8A) are the main islet related autoantibodies applied clinically. In addition, combined testing of islet related autoantibodies is of important significance in the prediction and diagnosis of T1DM.