Rice is a staple food crop consumed by billions globally. However, rice consumption is associated with a high glycaemic response, which has negative health implications. Identifying rice varieties with intrinsically lower glycaemic responses would benefit public health. Recent research has uncovered genomic loci in rice associated with glycaemic response in rice. However, diagnostic assays are needed to efficiently characterize these loci in rice germplasm and breeding populations. This review summarizes current knowledge on low glycaemic rice genetics and proposes strategies for diagnostic assay development. Specific loci implicated in modulating starch digestion and glycaemic response are highlighted. Developing robust, high-throughput molecular marker platform for low glycaemic rice loci will accelerate varietal improvement and enhance the nutritional qualities and health benefits of this essential crop. The review also explores the role of other grain components, such as lipids and proteins, and their interactions with starch in influencing the glycaemic index (GI).