This systematic review and meta-analysis evaluated the efficacy of Resistance Exercise Training (RET) on metabolic health, body composition, and muscle strength in older adults with type 2 diabetes (T2DM). Electronic databases were systematically searched and meta-analyses were conducted using random-effects models. Meta-regression analyses were also performed to explore potential sources of heterogeneity. Nineteen randomized controlled trials (RCTs) met the inclusion criteria. RET significantly improved hemoglobin A1c (MD: -0.51, P <
0.0001) and fasting blood glucose (mean differences: MD: -1.43 mg/dl, P = 0.04), though insulin levels remained unchanged. Lipid profile analysis revealed significant reductions in triglycerides (MD: -0.32, P = 0.03), total cholesterol (MD: -7.08, P = 0.005), and low-density lipoprotein (MD: -1.91, P = 0.05), without significant changes in high-density lipoprotein. RET increased lean mass and reduced waist circumference but had no effect on body weight and fat mass. Muscle strength improved significantly, but there was no impact on blood pressure or heart rate. These findings suggest that RET is beneficial for enhancing glycemic control, lipid profiles, lean mass, and muscle strength in older adults with T2DM, while its effects on body weight, fat mass, and cardiovascular health remain inconclusive. Further studies are needed to explore long-term effects.