The number of elderly people is increasing worldwide as well as the age-associated diseases, such as the type 2 diabetes. The consequences are disastrous for elderly patients as well as for healthy ageing. It has been clinically demonstrated that with physiological ageing it exists already a resistance to the action of insulin leading to slightly increased glycemia and insulin levels. Several causes have been postulated for this insulin resistance with ageing, among them the alteration of insulin receptor (IR) number, of IR signal transduction as well as environmental changes. Much more studies are needed to understand correctly the age-related changes of IRs mainly in humans. In this review, we will summarize our actual knowledge in the context of ageing on IRs trying to include it in a more general picture of receptor physiology with ageing. The understanding of the IR physiology with ageing will help to develop more adequate preventive and therapeutic strategies in order to decrease the burden of the complications related to insulin resistance.