Background: Cryolipolysis is a non-invasive procedure designed to target subcutaneous adipose tissue in obese patients that has emerged as a potential therapeutic approach for modifying insulin resistance(IR ) in T2DM individuals. Aim: to evaluate the efficacy of cryolipolysis in reducing IR among patients diagnosed with T2DM patients exhibiting abdominal obesity. Research design: Randomized, two-group pre-post-test, controlled design. Patients and Methods: sixty females with T2DM exhibiting abdominal obesity were enrolled. The participants were randomly and equally divided either in Group A (cryolipolysis in combination with aerobic exercise ), or in Group B (aerobic exercise therapy alone) for three months. All variables measured Pre-and post-study, including (HbA1c, FBG, fasting insulin level, HOMA testing). Results: there was statistically significant decrease in all measured parameters of groups A and B post-treatment compared with pre-treatment with a significant increase in water content, muscle mass, and a significant decrease in fat content and visceral fat of groups A and B post-treatment compared with pre treatment. Following the intervention, Group A significantly reduced fat content and visceral fat compared to Group B. However, there were no significant differences in waist-hip ratio, water content, and muscle mass between the two groups post-treatment. Significant improvements in metabolic parameters were observed in Group A compared to Group B. Group A showed a significant decrease in FBG, insulin levels, HbA1c, and HOMA-IR. Conclusions: Cryoliopolysis is one of the effective strategies for addressing localized fat deposits that enhance glucose absorption and favorable changes in HbA1c and HOMA-IR, that improve insulin sensitivity.