Type 2 Diabetes Mellitus (T2DM) is a common metabolic disorder characterized by defective insulin secretion by pancreatic β-cells and insulin resistance in target tissues. This review examines the key aspects of T2DM, including molecular mechanisms and pathways involved in insulin metabolism, as well as the association between T2DM and cardiovascular complications. The review highlights the global trends of T2DM, the roles of major risk factors such as obesity, lifestyle factors, genetic predispositions, gut dysbiosis, epigenetics, and mitochondrial deregulation. It also discusses the pathological conditions perpetuating T2DM, such as nutritional factors, physical activity, gut dysbiosis, and metabolic memory. Additionally, the review explores the molecular mechanisms linking T2DM and insulin resistance, and the development of cardiovascular disease as a significant complication of T2DM. The review emphasizes the complex interplay between genetic and environmental factors, and the importance of maintaining proper insulin secretion and action to prevent the progression of T2DM.Type 2 Diabetes Mellitus (T2DM) is a common metabolic disorder characterized by defective insulin secretion by pancreatic β-cells and insulin resistance in target tissues. This review examines the key aspects of T2DM, including molecular mechanisms and pathways involved in insulin metabolism, as well as the association between T2DM and cardiovascular complications. The review highlights the global trends of T2DM, the roles of major risk factors such as obesity, lifestyle factors, genetic predispositions, gut dysbiosis, epigenetics, and mitochondrial deregulation. It also discusses the pathological conditions perpetuating T2DM, such as nutritional factors, physical activity, gut dysbiosis, and metabolic memory. Additionally, the review explores the molecular mechanisms linking T2DM and insulin resistance, and the development of cardiovascular disease as a significant complication of T2DM. The review emphasizes the complex interplay between genetic and environmental factors, and the importance of maintaining proper insulin secretion and action to prevent the progression of T2DM.