This meta-analysis investigated the impact of resistance exercise training (RET) on metabolic syndrome (MetS) markers in patients with type 2 diabetes mellitus (T2DM) by synthesizing evidence from randomized controlled trials (RCTs). A systematic search was conducted in four databases up to September 2024. Data were analyzed using random-effects models to calculate mean differences (MD) and 95 % confidence intervals (CI). Fifty RCTs involving 2271 participants (1186 in the intervention group, 1085 in the control group) were included. RET significantly improved key MetS markers, including reductions in fasting blood glucose (MD = -7.09 mg/dl
p <
0.00001), triglyceride (MD = -14.05 mg/dl
p <
0.0001), systolic (MD: -4.13 mmHg
p = 0.0004) and diastolic (MD: -2.03 mmHg
p = 0.02) blood pressure, and waist circumference (MD = -2.18 cm
p <
0.00001). Additionally, RET was associated with increased high-density lipoprotein levels (MD: 1.86 mg/dl
p = 0.002). Subgroup analyses indicated consistent benefits across varing intervention durations and participant genders, underscoring the broad applicability of RET for diverse T2DM populations. These findings suggest that RET is an effective intervention for improving MetS markers in individuals with T2DM. However, limitations such as high heterogeneity and small sample sizes may affect generalizability.