Dysfunction of nuclear receptors (NRs), which are critical for maintaining renal lipid homeostasis, largely contributes to the progression of diabetic nephropathy (DN) by promoting renal lipid accumulation. However, there are few therapies in modern medicine that effectively inhibit renal lipid accumulation by modulating NRs. In this review, we first summarize recent advances in NRs-mediated renal lipid accumulation in DN. Then, we summarize recent studies on the effects and mechanisms of Chinese herbal medicines on DN and highlight the effects of Chinese herbal medicines on renal lipid accumulation via NRs. In addition, the advantages and limitations of traditional Chinese medicine in the treatment of DN via NRs-mediated renal lipid accumulation are analyzed, and the modulation of renal lipid accumulation via NRs is emphasized as a promising therapeutic strategy for the treatment of DN.