This paper reviews the progress in treatment regimens involving traditional Chinese medicine and research on common clinical endocrine diseases in 2021, to provide a reliable basis for the traditional Chinese medicine treatment of endocrine diseases. In 2021-2022, research on traditional Chinese medicine for endocrine diseases has been focused on pathogenesis. We have summarized the results of the use of traditional Chinese medicine and herbal extracts for treating common endocrine system diseases in 2021, focusing on the following aspects. (1) Chinese herbal extracts or active ingredients, such as echinatin, breviscapine, and puerarin, can treat metabolic-associated fatty liver disease by inhibiting inflammation and oxidative stress, improving lipid metabolism, and regulating intestinal flora. (2) Chinese herbal extracts or active ingredients, such as Juglandis Semen extracts, Momordica charantia saponins, and Anemarrhenae Rhizoma extracts can treat type 2 diabetes by reducing insulin resistance, improving pancreatic beta cell function, and regulating intestinal microbial disorders. (3) Chinese herbal extracts or active ingredients, such as berberine, astragaloside IV, and Scutellariae Barbatae Herba polysaccharides, can treat diabetes-related complications by improving mitochondrial function, regulating autophagy, and inhibiting apoptosis and pyroptosis. (4) Chinese herbal medicines and herbal extracts or active ingredients, such as berberrubine and Resedaodorata, can treat hyperuricemia by activating the Janus kinase 2/signal transducers and activators of transcription 3 signaling pathway and inhibiting toll-like receptor 4/NOD-like receptor family, pyrin domain-containing protein 3 signaling to increase urate excretion. (5) Herbal extracts or active ingredients, such as ginsenoside Rb1, corylin, and Scutellariae Radix polysaccharides, can exert anti-obesity effects by promoting the browning of white adipocytes, activation of brown adipose tissue, and regulation of intestinal flora. (6) Chinese herbal extracts or active ingredients, such as diosgenin and Prunellae Spica extract, are able to treat thyroid-related diseases by inhibiting nucleotide-binding oligomerization domain-like receptor protein 3 inflammatory vesicle activation, regulating the expression of proliferating cell nuclear antigen, and cadherin 1, and upregulating the ubiquitination of interferon regulatory factor 4.