Chronic, non-infectious diseases contribute to nearly three-quarters of deaths worldwide. Type 2 diabetes mellitus (T2DM) together with cardiovascular disease, are the two most common conditions in this category. Insulin resistance, obesity, elevated blood fats, and high blood pressure are typical hallmarks of T2DM and its development and are also significant risk factors for diabetes-related cardiovascular events. The prolonged nature of T2DM and the complications that can go alongside make the condition one of the most costly diseases for healthcare systems hence finding cost-effective therapeutic strategies should be of high importance. Many functional plants and their bioactive components have shown to exert anti-diabetic effects, including Nigella sativa, commonly known as black cumin. Previous studies also reported promising benefits of Nigella on cardiometabolic health. How these effects manifest in individuals with T2DM and those who are prediabetic was analysed in this systematic review and meta-analysis. The review included 11 randomised controlled trials with a total of 666 subjects. The review focused on cardiometabolic measures such as body measurements, blood sugar control, insulin resistance and secretion, blood fats, and markers of inflammation and oxidative stress. Nigella supplementation appeared to have favourable effects on blood sugar control overall but with no changes in the outcomes of oral glucose tolerance tests. Furthermore, Nigella appeared to positively influence on various blood fats, and markers of inflammation and oxidative stress. There were no changes to fasting insulin, insulin resistance, triglyceride, high-density lipoprotein (HDL)-Cholesterol and body mass index (BMI) when compared to the control group. Yet, in a sub-analysis Nigella supplementation enhanced serum levels of 'good' HDL-Cholesterol in a particular group. An improvement in insulin resistance and a decrease in BMI were seen in supplementation trials lasting over 8-weeks with doses of over 1 g/day of Nigella. The authors concluded that Nigella has the potential to improve cardiometabolic parameters by favourably influencing blood sugar metabolism and blood fats, inflammation, and oxidative stress in individuals with prediabetes and T2DM. Hence Nigella supplementation has promsing potential as an adjunct therapeutic in the management of prediabetes and T2DM.