Diabetes, a leading global chronic disease, poses a significant health threat, with physical inactivity being a major risk factor for its development and progression. This guideline, developed by the Chinese Society of Endocrinology, synthesizes the latest evidence and expert insights to provide evidence-based recommendations for physical activity and exercise therapy in adults with type 2 diabetes (T2D). It is generally recommended that all adult patients with T2D engage in at least 150-300 min of moderate-intensity aerobic exercise per week, or a minimum of 75-150 min of vigorous-intensity exercise, or an equivalent combination of moderate- and vigorous-intensity exercise (with a total exercise volume of at least 450 metabolic equivalent-min per week). For patients with T2D who are capable, moderate over-exercise and a combination of different forms of exercise (aerobic, resistance, flexibility, and/or balance training) are encouraged. The guideline also underscores the necessity of targeting specific subgroups of patients with T2D, including the elderly, individuals with obesity or pre-obesity, cardiovascular disease, hypertension, chronic kidney disease, metabolic dysfunction-associated steatotic liver disease, and/or diabetic foot and its high-risk populations. The guideline provides a scientific basis for clinicians to develop personalized exercise guidance and recommendations, with the goal of improving the disease prognosis of the relevant population.