Type 2 diabetes (DM2) and obesity are chronic diseases that often coexist with considerable morbidity and mortality. Approximately 85 % of all DM2 patients have a body mass index (BMI) ranking them as overweight (BMI 25‑29,9 kg/m ² ) or obese (BMI > 30 kg/m ² ). Metabolic surgery is the only treatment for diabetes that results in long-term remission in 23 to 60 % of patients in the office depending on the preoperative duration of diabetes and the severity of the disease. This review presents evidence for the use of metabolic surgery (CM) as a primary treatment for DM2, potential mechanisms of its effects, and recommendations for its use in expanded patient populations.