BACKGROUND: This meta-analysis investigated the influence of exercise on cognitive function in people living with diabetes. METHODS: Stringent criteria for literature inclusion and exclusion were defined. Searches were conducted across four English databases to gather randomized controlled trials investigating exercise interventions for cognitive function in people living with diabetes. Outcome indicators from 1193 subjects across 12 articles were analyzed using RevMan 5.4 software. RESULTS: Exercise intervention demonstrated the ability to mitigate cognitive decline in people living with diabetes, with a combined effect size (standardized mean difference) of 0.91, 95% CI 0.28 to 1.54, p < 0.00001. The intervention effect showed significant modulation by intervention content (I2 95%), intervention duration (I2 95%), intervention frequency (I2 95%), and intervention cycle (I2 96%). Among these factors, multi-component exercise, sessions > 40 minutes, exercise frequency > 4 times per week, and sustained exercise for > 6 months were paramount, all with p < 0.05. CONCLUSION: Exercise intervention emerges as a viable strategy for delaying cognitive decline in people living with diabetes. Its efficacy is subject to modulation by various variables. Optimal intervention includes multi-component exercise, individual sessions lasting 40 to 60 minutes, exercising > 4 times a week, and continuous exercise for over 6 months.

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