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OBJECTIVE: To systematically evaluate the effects of high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT) on body composition and glucose metabolism-related indexes in overweight or obese patients with type 2 diabetes and to compare the improvement effect of the two exercise modalities, thereby providing a reference basis for the development of exercise prescription for overweight or obese patients with type 2 diabetes. METHODS: The Cochrane Library, PubMed, EMbase, Web of Science, CNKI, CBM, WanFang, and ClinicalTrials.gov were searched for randomized controlled trials comparing the effects of HIIT and MICT interventions on body composition and glucose metabolism-related indicators in overweight or obese patients with type 2 diabetes. The search was conducted from database inception to June 2022. Meta-analysis of outcome indicators was performed using RevMan 5.4. RESULTS: (1) A total of 13 randomized controlled trials with 371 subjects were included, and the overall quality of the included studies was relatively high. (2) There was no significant difference in the improvement of body composition between HIIT and MICT [body mass: weighted mean difference (WMD)=2.44, 95% confidence interval (CI): -3.01-7.89, P > 0.05; body mass index: WMD=0.28, 95%CI: -1.21-1.77, P > 0.05; waist circumference: WMD=2.16, 95% CI: -2.04-6.35, P > 0.05; body fat percentage: WMD=0.47, 95%CI: -2.11-3.05, P > 0.05). (3) The results of subgroup analysis showed that there was a significant difference in body mass and body mass index between the “training cycle ≥ 12 weeks” subgroup and the “training frequency ≤ 3 times/week” subgroup (training cycle ≥ 12 weeks subgroup: WMD=4.25, 95% CI: 0.90-7.59, P=0.01; WMD=2.71, 95%CI: 1.92-3.51, P < 0.000 01; training frequency ≤ 3 times/week subgroup: WMD=5.14, 95%CI: 1.7-8.57, P=0.003; WMD=1.67, 95% CI: 0.66-2.67, P=0.001). (4) The results of sensitivity analysis showed that there was a significant difference in body fat percentage between the HIIT and MICT groups (WMD=2.17, 95% CI: 1.20-3.14, P < 0.000 1), while there was no significant difference in the improvement of glucose metabolism between the HIIT and MICT groups (fasting blood glucose: WMD=0.31, 95% CI: -0.17-0.79, P > 0.05; glycosylated hemoglobin: WMD=0.01, 95% CI: -0.19-0.20, P > 0.05; insulin resistance index: WMD=-0.14, 95%CI: -0.71-0.42, P > 0.05). (5) The results of subgroup analysis showed that fasting blood glucose was significantly different in the subgroup of “training frequency ≤ 3 times/week” (WMD=0.92, 95% CI: 0.25-1.60, P=0.007) and glycosylated hemoglobin was significantly different in the “training frequency > 3 times/week” subgroup (WMD=-0.2, 95% CI: -0.3 to -0.1, P < 0.000 1). CONCLUSION: Overall, there is no significant difference between HIIT and MICT in improving body composition such as body mass, body mass index, waist circumference, body fat percentage as well as improving glucose metabolic indexes such as fasting blood glucose, glycated hemoglobin and insulin resistance index in overweight or obese patients with type 2 diabetes. When the training period is ≥ 12 weeks and the training frequency is ≤ 3 times/week, MICT has a better effect on the improvement of body mass as well as body mass index. [ABSTRACT FROM AUTHOR]