Germanium is an important mainstream material for many nanoelectronic and sensor applications. The understanding of diffusion at an atomic level is important for fundamental and technological reasons. In the present review, we focus on the description of recent studies concerning n-type dopants, isovalent atoms, p-type dopants, and metallic and oxygen diffusion in germanium. Defect engineering strategies considered by the community over the past decade are discussed in view of their potential application to other systems.