The invention discloses an insulin skin medication paste for diabetes and a preparation method. The insulin skin medication paste is prepared by the following steps: a, dissolving insulin into a triethanolamine-hydrochloric acid buffer liquid, adding a polylactic acid hollow fiber, and carrying out vacuum treatment so as to obtain a polylactic acid fiber with insulin; b, mixing the polylactic acidfiber with sodium salicylate, sitosterol, lecithin, ceramide, ethyecellulose and glycerinum so as to obtain a composite gel ointment; c, under an air isolated condition, coating the surface of a substrate by the composite gel ointment, adhering to a diaphragm, cutting, and packaging, thereby obtaining the insulin skin medication paste. The preparation method has the beneficial effects that the insulin skin medication paste disclosed by the invention has a slow release effect, through micro acupuncturing of the polylactic acid fiber and a skin expansion function of salicylic acid, the skin medication effect of the paste can be effectively improved, and the paste is applicable to an abdomen part, has long-lasting medicinal effects, is very convenient to use and has good application prospects.