The prevalence of gestational diabetes mellitus (GDM) is dramatically higher in Indigenous compared with non-Indigenous populations in Canada. In this scoping review we synthesize the existing literature regarding GDM among Indigenous peoples in Canada, including social and structural determinants that contribute to its higher prevalence in this population. Seven themes related to GDM in Indigenous populations emerged from a synthesis of the 44 included articles. The themes were GDM prevalence and trends; risk factors; screening; diagnosis and treatment; maternal outcomes; child outcomes; systemic barriers; and Indigenous perceptions, concerns and health behaviours. The findings from this review suggest culturally appropriate health care and improved screening practices may help to mitigate the high prevalence and poor health outcomes associated with GDM in Indigenous communities across Canada. More community-driven, participatory research that includes the social determinants of health and a culturally safe lens is required to assess the effects and reduce the impact of GDM in this population.