The prevalence of diabetes is rapidly increasing worldwide and can lead to a range of severe health complications that have the potential to be life-threatening. Patients need to monitor and control blood glucose levels as it has no cure. The development of non-invasive techniques for the measurement of blood glucose based on photoacoustic spectroscopy (PAS) has advanced tremendously in the last couple of years. Among them, PAS in the mid-infrared (MIR) region shows great promise as it shows the distinct fingerprint region for glucose. However, two problems are generally encountered when it is applied to monitor real samples for in vivo measurements in this MIR spectral range: (i) low penetration depth of MIR light into the human skin, and (ii) the effect of other interfering components in blood, which affects the selectivity of the detection system. This review paper systematically describes the basics of PAS in the MIR region, along with recent developments, technical challenges, and data analysis strategies, and proposes improvements for the detection sensitivity of glucose concentration in human bodies. It also highlights the recent trends of incorporating machine learning (ML) to enhance the detection sensitivity of the overall system. With further optimization of the experimental setup and incorporation of ML, this PAS in the MIR spectral region could be a viable solution for the non-invasive measurement of blood glucose in the near future.