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Metabolic syndrome (MS), which involves visceral obesity, hyperglycemia, hypertension, and dyslipidemia, has become a global health challenge. Preventive measures include lifestyle changes, dietary treatments, etc. Konjac has been widely used as a culinary ingredient and traditional Chinese medicine in Asian countries for thousands of years. The main component of the konjac tuber is konjac glucomannan (KGM), a kind of hydrocolloid dietary fiber. Many health problems and diseases are affected by the gut microbiota, which may provide an alternative for preventing disease. In this review, we describe the prevention and treatment of MS using KGM, with a focus on its impact in relation to the regulation of gut microbes. Developing a comprehensive understanding of the role played by KGM via the gut microbiota will help us to determine the underlying mechanisms of KGM for the treatment of diseases associated with the gut microbiota.