Diverse clinical trial participation is crucial for effective new drug development, but historically, trials lacked diversity, primarily including white, middle-class males. Efforts to increase diversity include the NIH Revitalization Act and FDA's recent draft guidance on diversity action plans. Despite progress, underrepresented groups remain underrepresented. Challenges include mistrust, logistical barriers, and financial constraints. Organizations like Johnson & Johnson and the NIH All of Us Research Program are working to increase diversity through partnerships, technology, and community engagement.