Objective: To study the clinical effect of Musk Heart Drops in the treatment of ischemic heart failure (IHF) complicated with diabetes. Methods: 120 patients with IHF and diabetes admitted to Xiangshan First People’s Hospital from May 2023 to May 2025 were selected as the research subjects. They were divided into a control group and an observation group, with 60 patients in each group, using a random number method. The control group received standard treatment, while the observation group received standard treatment plus Musk Heart Drops. The treatment lasted for 3 months. The treatment effects, symptom scores, 6-minute walk distance, cardiac function, serum indicators, and blood glucose indicators were compared and analyzed. Results: The observation group demonstrated a significantly higher treatment efficacy compared to the control group (P < 0.05). Post-treatment assessments revealed that the observation group had lower symptom scores, a longer 6-minute walking distance, and improved left ventricular function, as indicated by a higher left ventricular ejection fraction (LVEF) and reduced left ventricular end-systolic diameter (LVESD) and end-diastolic diameter (LVEDD) (P < 0.05). Additionally, plasma NT-proBNP levels were significantly lower in the observation group (P < 0.05). Metabolic parameters also improved, with the observation group showing lower fasting blood glucose (Glu) and glycated hemoglobin (HbA1c) levels than the control group (P < 0.05). Conclusion: Musk Heart Drops combined with standard treatment can control the condition of patients with IHF and diabetes, improve symptoms, 6-minute walk distance, cardiac function, NT-proBNP, and blood glucose levels, demonstrating significant application value.