The ARISE-HF trial aimed to characterize the clinical characteristics of individuals with diabetic cardiomyopathy (DbCM), a form of Stage B heart failure (HF) at high risk for progression to overt disease. The study included 691 participants with a mean age of 67.4 years, 50% of whom were female. The median duration of type 2 diabetes mellitus (T2DM) was 14.5 years. Key findings included elevated levels of N-terminal pro-B type natriuretic peptide and high sensitivity cardiac troponin T, reduced global longitudinal strain, impaired diastolic relaxation, and well-preserved Kansas City Cardiomyopathy Questionnaire (KCCQ) scores despite marked impairment in physical activity and exercise capacity as measured by the Physical Activity Scale of the Elderly (PASE) and cardiopulmonary exercise testing (CPET). Cluster analysis identified four phenogroups with distinct characteristics, including younger age, higher blood pressures, lower BMI, and more severe diastolic dysfunction and left ventricular hypertrophy. These findings provide a comprehensive clinical characterization of individuals with T2DM and features of Stage B HF, which may help in the diagnosis and management of DbCM. The study also highlights the need for further research to understand the heterogeneity within the diagnosis of DbCM and to develop efficient strategies for its identification.The ARISE-HF trial aimed to characterize the clinical characteristics of individuals with diabetic cardiomyopathy (DbCM), a form of Stage B heart failure (HF) at high risk for progression to overt disease. The study included 691 participants with a mean age of 67.4 years, 50% of whom were female. The median duration of type 2 diabetes mellitus (T2DM) was 14.5 years. Key findings included elevated levels of N-terminal pro-B type natriuretic peptide and high sensitivity cardiac troponin T, reduced global longitudinal strain, impaired diastolic relaxation, and well-preserved Kansas City Cardiomyopathy Questionnaire (KCCQ) scores despite marked impairment in physical activity and exercise capacity as measured by the Physical Activity Scale of the Elderly (PASE) and cardiopulmonary exercise testing (CPET). Cluster analysis identified four phenogroups with distinct characteristics, including younger age, higher blood pressures, lower BMI, and more severe diastolic dysfunction and left ventricular hypertrophy. These findings provide a comprehensive clinical characterization of individuals with T2DM and features of Stage B HF, which may help in the diagnosis and management of DbCM. The study also highlights the need for further research to understand the heterogeneity within the diagnosis of DbCM and to develop efficient strategies for its identification.