Diabetic kidney disease (DKD), as the leading cause of end-stage renal disease, involves complex pathophysiological mechanisms. In recent years, macrophage-mediated immune metabolic dysregulation has been identified as a critical driver of DKD progression, where the phenotypic switching between M1 and M2 macrophages is governed by specific metabolic reprogramming (glycolysis versus oxidative phosphorylation). Nuclear factor erythroid 2-related factor 2 (Nrf2), a core transcription factor for cellular antioxidant response, not only regulates redox homeostasis but also influences macrophage polarization, thereby exerting renoprotective effects. However, the precise molecular mechanisms by which Nrf2 modulates macrophage metabolic reprogramming to affect polarization within the DKD microenvironment remain elusive. This review aims to systematically elucidate the molecular mechanisms of Nrf2 in regulating metabolic reprogramming and polarization of macrophage in DKD, providing new insights and potential therapeutic targets for the precision treatment of DKD.