The current approach to managing diabetes mellitus in obese patients focuses on a comprehensive strategy that addresses both conditions simultaneously. Central to this approach is weight management through lifestyle modifications, including dietary changes and increased physical activity. Caloric restriction, with an emphasis on balanced nutrition that limits simple sugars and unhealthy fats while promoting fiber-rich foods, plays a crucial role. Regular exercise helps improve insulin sensitivity and facilitates weight loss. Pharmacotherapy may include medications that not only lower blood glucose levels but also aid in weight reduction, such as GLP-1 receptor agonists and SGLT-2 inhibitors. These agents have shown benefits beyond glycemic control by promoting weight loss and reducing cardiovascular risk factors. Bariatric surgery is considered for severely obese individuals with diabetes which is difficult to control with lifestyle modifications and medications alone. It can lead to significant weight loss and often results in remission or improvement of diabetes. Continuous monitoring of blood glucose levels, along with regular assessments of lipid profiles, kidney function, and cardiovascular risk factors, guides treatment adjustments and helps prevent complications. Patient education and ongoing support are essential to promote adherence to treatment plans and empower individuals to manage both diabetes and obesity effectively. Integrating these approaches ensures a holistic and personalized management strategy tailored to the unique needs of obese patients with diabetes mellitus.