Type 2 diabetes mellitus (T2DM) is a frequent companion associated with a high risk of cardiovascular events; both diseases share various physiopathological mechanisms and risk factors, resulting in a chronic systemic inflammatory state that leads to progressive vascular changes, requiring intensified treatment. However, it is still unknown how the correlation between glucose level benefits and cardiovascular health is optimized through exercise, resulting in a reduction and control of cardiometabolic levels. Additionally, the literature does not present a compilation of studies indicating the recommended types of exercises, intensities, and durations when associated with a specific diet. The main objective was to analyze the literature on whether physical exercise and the implementation of a diet have a positive impact on reducing cardiovascular risk factors and to identify the best-recommended types of exercises, intensity, and duration. Data collection took place between May and June 2023, using the Scielo, Medline, PubMed, and PEDro databases. The inclusion criteria were articles published from 2018 to 2023, in Portuguese and English, available in full, with the study type being randomized controlled trials, and the target audience being elderly individuals with T2DM. A total of 59 articles were found, and only 14 met the criteria. The results showed that there is a discrepancy when treatments focus solely on dietary changes without incorporating exercise; improvements are limited to body composition and weight reduction. However, when combined with regular high-intensity exercises and aerobic exercises for over a year, there was acute and chronic glycemic control, reduction in resting systolic blood pressure, and resting heart rate, proving crucial in inducing both cardiometabolic and psychological benefits.