Epidemiological studies have demonstrated that a range of metabolic diseases, particularly type 2 diabetes and obesity, have reached epidemic proportions. These chronic conditions not only diminish the equality of life for individuals but also impose significant financial burdens on families and healthcare systems. While various therapeutic medications can effectively manage the progression of these diseases, they often come with adverse side effects. In contrast, natural products and their metabolites, such as ellagic acid (EA) and urolithins derived from a variety of plant species, have gained attention for their wide-ranging biological activities, diverse classes, and minimal side effects. Emerging research suggests that EA and urolithins may offer promising therapeutic effects in the treatment of metabolic disorders. This review aims to provide a comprehensive overview of the therapeutic effects and associated signaling pathways of EA and its metabolite urolithins in various metabolic diseases, offering valuable insights for their clinical applications and the potential development of novel food and medicine homologous therapies.