Dietary interventions that restrict carbohydrate intake for the management of diabetes are of particular interest to researchers, healthcare providers, and patients. Based on evidence of moderate to low certainty from 23 randomized trials (n=1357), evidence synthesis suggests that patients who adhere to low or very low carbohydrate diets for six months might achieve diabetes remission without adverse consequences. But the definition of low and very low carbohydrate diets, the long term health effects of carbohydrate restricted diets, and the working definitions of diabetes remission are debated, requiring further investigation, particularly for longer term health outcomes based on evidence from randomized trials.