Nanotechnology has rapidly grown in various research fields, including phytomedicine to treat oxidative stress in diabetes. This study aimed to evaluate the effect of the nanoextract of Acalypha hispida leaves on antioxidant defense and microstructure of the liver and kidney in diabetic rats. A total of 24 rats were divided into 6 groups (n = 4): normal rats, diabetic rats, and diabetic rats treated with metformin at 88 mg/kg, extract at 300 mg/kg, and nanoextract at 30 and 60 mg/kg body weight (BW). BW, blood biochemistry (alanine aminotransferase, aspartate aminotransferase, urea, and creatinine), total superoxide dismutase (SOD), catalase (Cat), and malondialdehyde (MDA) were evaluated. Histomorphological and immunohistochemical (Cu, Zn-SOD) analyses were observed in the liver and kidney. The extract and nanoextract of A. hispida improved blood biochemistry in diabetic rats. Both decreased MDA level and increased total SOD and Cat activity in the liver and kidney of diabetic rats. Cu, Zn-SOD contents of the liver and kidney in the extract and nanoextract-treated diabetic were higher than in the diabetic control. The nanoextract at 60 mg/kg BW showed the best effect in suppressing microstructure damage to the liver and kidney. The study concluded that the nanoextract of A. hispida leaves increased antioxidant defense and suppressed microstructure damage in the liver and kidney of diabetic rats.