OBJECTIVE: This study aimed to evaluate the effects of exercise on aerobic capacity in type 2 diabetes mellitus (T2DM) patients through a systematic review and meta-analysis of randomized controlled trials. METHODS: A comprehensive search was conducted in Web of Science, PubMed, Embase, Cochrane, and Scopus from inception to September 8, 2024. The Cochrane risk assessment tool was used to assess the methodological quality of the included literature. Data were pooled using random-effects models to calculate standardized mean difference (SMD) and 95% confidence interval. RESULTS: Fourteen studies involving 803 participants (437 in exercise groups and 366 in control groups) were included. Exercise significantly improved aerobic capacity inT2DM patients (SMD 0.62; p < 0.00001). Subgroup analyses revealed that multicomponent training (SMD 0.74; p = 0.0007), session duration >= 60min (SMD 0.75; p < 0.00001), frequency > 3 times per week (SMD 0.89; p = 0.0003), and weekly time >= 180min (SMD 0.86; p < 0.00001) were more effective. Younger patients (< 45 years) showed greater improvements (SMD 0.87; p = 0.01) compared to older patients. CONCLUSION: Exercise improved aerobic capacity in T2DM patients, with multicomponent training emerging as the most effective intervention. Clinicians should recommend that T2DM patients engage in exercise at least 3 times per week, with sessions lasting 60min or more, to achieve a cumulative weekly time of 180min or more.

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