PURPOSE: The evidence for effective non-pharmacological management of type 2 diabetes in children and young adults is scarce. This systematic review aims to identify the available evidence for non-pharmacological interventions in managing type 2 diabetes in children and young adults. METHODS: A systematic search of OVID MEDLINE, Ovid Emcare, EMBASE, CINAHL, Cochrane, APA PsycINFO, Joanna Briggs, ACP Journal Club, Global Health, Scopus databases, INFORMIT, Circumpolar Health, Native Health Database, Indigenous Studies Portal, OpenGrey and Clinicaltrials.gov was performed up to March 2024. Information on author, year, study design, setting and population, intervention characteristics, and results were extracted by three reviewers independently. RESULTS: Seven studies met criteria for inclusion. Very low-energy diet (VLED) was associated with reduction in hemoglobin A1c (HbA1c), weight, and body mass index (BMI). No other interventions (intensive group-based lifestyle program, occupational-therapist conducted support program or peer support program) improved HbA1c. Interventions positively impacted well-being, mental health and cardiometabolic outcomes. DISCUSSION: Evidence for non-pharmacological management of youth onset type 2 diabetes is scarce. Available evidence demonstrated that VLED is associated with improved glycemia and weight loss. The role of social support from peers, family, and health professionals shows mixed results.