Diabetic wounds are a type of wound that is characterized by protracted and refractory. In recent years, the use of mesenchymal stem cell-derived exosome(MSC-Exo)in wound treatment has made certain progress, especially bone marrow mesenchymal stem cell exosome (BMSC-Exo༉also have get achievement in wound treatment, and this paper aims to study whether bone marrow mesenchymal stem cell-derived exosomes can promote the healing of diabetic wound and its mechanism. We conducted in vivo and in vitro experiments to verify whether BMSC-Exo can promote wound healing and promote the proliferation and migration of fibroblasts after high glucose treatment in diabetic rats. The expression of NLRP3, IL-18, IL-1β, caspase-1,and GSDMD proteins in rats and cells in each group was detected to verify the relationship between the mechanism of BMSC-Exo promoting wound healing and cell pyroptosis. The results showed that BMSCs-Exo can significantly improve the wound healing rate in diabetic rats and promote the proliferation and migration of fibroblast under high glucose conditions. At the same time, we confirmed that the pyroptosis in diabetic rat wound and fibroblast in high sugar was significantly increased, and BMSCs-Exo could significantly inhibit the pyroptosis in diabetic rat wound and fibroblast. These results suggest that BMSC-Exo inhibits cell pyroptosis through NLRP3/ caspase-1/GSDMD pathway in vivo and in vitro, and promotes wound healing in diabetic rats.