According to the current guidelines for the intervention treatment of patients with coronary heart disease, the primary and secondary prevention of cardiovascular events is long-term pharmacotherapy with platelet function inhibitors. Although undeniable progress has been made in the use of this group of medicaments, there are, however, issues calling for further investigation in the population of diabetic patients in particular. Along with the general principles of thrombosis, there are mechanisms that cause additional platelet hyperactivity in the presence of insulin deficiency and insulin resistance, metabolic and cellular disorders induced by hyperglycemia. The risk of resistance to standard antithrombotic therapy suggests a search for alternative ways to inhibit platelet aggregation, which is particularly relevant in diabetic patients.