Objective: Diabetes clinical teaching has long relied on theoretical instruction and static case studies, which leaves residents ill-prepared to manage dynamic blood glucose fluctuations and complex clinical scenarios. This study aims to explore the effectiveness of integrating Ambulatory Glucose Profile (AGP) with scenario simulation in enhancing residents’ clinical reasoning for diabetes management. Methods: Sixty endocrinology residents were randomly assigned to a control group and an intervention group. Both groups underwent the same conventional clinical teaching curriculum. Additionally, the control group completed an 8-hour AGP training program consisting of 4 hours of didactic instruction and 4 hours of self-directed practice with static case analysis. The intervention group received an 8-hour integrated program combining AGP analysis with high-fidelity scenario simulation and structured debriefing according to Kolb’s experiential learning cycle. Teaching outcomes were evaluated through theoretical assessments (primary outcome), Objective Structured Clinical Examinations (OSCEs), Mini-Clinical Evaluation Exercises (Mini-CEX), and satisfaction surveys. Results: The intervention group demonstrated significantly higher scores than the control group in the primary outcome (theoretical knowledge), across all six OSCE stations (including history taking, physical examination, skill operation, medical communication, medical record writing, and case analysis), as well as in multiple Mini-CEX dimensions (history taking, physical examination, communication skills, clinical judgment, and organizational efficiency) (all P<0.05). No significant differences were observed between the two groups in humanistic care and teaching satisfaction (P>0.05). Conclusions: The integrated teaching approach combining AGP with scenario simulation demonstrated preliminary effectiveness in enhancing residents’ comprehensive clinical management skills and may serve as a valuable method for training clinical reasoning in diabetes care.