Diabetes mellitus (DM) is a significant public health and economic concern in Saudi Arabia, affecting more than 20% of adults. Insulin remains a cornerstone in DM management, but the country relies significantly on imported products. Hence, this results in high healthcare expenditures and variable availability. In line with Vision 2030, Saudi Arabia has prioritized the localization of insulin manufacturing to ensure sustainable access, reduce import dependency, and enhance national health security. This paper explores the clinical, economic, and policy implications of localizing insulin production in the Kingdom. The current work used a case study methodology to assess the feasibility, challenges, and strategic opportunities for the domestic production of innovative insulins, such as Degludec and IDegAsp. The study supports the development of public-private partnerships, investment in biotechnology infrastructure, and regulatory reform to foster a robust local biopharmaceutical ecosystem. By 2027, Saudi Arabia aims to meet 50% of its insulin demand through local production, making it the first country in the GCC region to produce innovative insulin. This initiative is expected to promote affordability and position the Kingdom as a leader in insulin innovation.