In people with diabetes, unloading high-risk areas of the foot by optimizing shoes or insoles can prevent ulceration. This systematic review aimed to summarize and evaluate the properties of shoes and insoles that reduce plantar pressure and the incidence of diabetic neuropathy, ulceration of the plantar forefoot in people with diabetic neuropathy. This article describes the influencing aspects of the foot and the improvement of the design of preventive footwear for patients with diabetes mellitus.