Many people have the misconception that diabetes is related to sugar, and many diabetic patients and their families even have the question: Is diabetes due to eating too much sugar? In fact, the pathogenesis of diabetes is very complex, and essentially diabetes is a metabolic disease. For example, type 2 diabetes, which accounts for 90% of diabetic patients, has a lot to do with personal habits of living and eating, and their own metabolic environment. Type 2 diabetes is typically a chronic disease that develops mainly due to a combination of inappropriate lifestyle and various genetic factors. As of 2011, scientists have identified more than 36 genes associated with the development of type 2 diabetes, however, even if all of these genes are combined, they only account for 10% of the overall genetic factors that predispose to diabetes; while poor lifestyle is considered to be an important factor in causing the disease. For example, obesity and overweight (BMI above 25), lack of physical activity, unhealthy eating habits, and high stress levels all increase the risk of developing the disease. Diabetes surgery is developed from weight loss surgery, mainly for obese type 2 diabetes patients. Patients can not only reduce their weight after surgery, but also enable more than 80% of diabetic patients to reach a clinical cure state, getting rid of glucose-lowering drugs and insulin, while improving the patient’s it metabolic condition and helping to treat metabolic diseases such as hypertension, hyperlipidemia, fatty liver, sleep apnea, etc. Therefore, in Academically diabetes surgery is known as metabolic surgery. Why is surgery able to treat diabetes and many metabolic diseases? In terms of the treatment mechanism of diabetes surgery, it is also closely related to improving metabolism. The main four aspects are as follows: 1) reduction of food intake and absorption, thus reducing energy intake and glucose metabolic load; 2) reduction of patient’s weight and insulin resistance due to simple obesity and fat accumulation; 3) alteration of intestinal-islet axis hormone secretion after gastrointestinal tract reconstruction, thus improving glucose metabolism; 4) alteration of intestinal flora after surgery, directly lowering blood sugar. Although the title of diabetic surgery is more understandable to patients, it is not rigorous enough. In order to standardize the name, the current academic regulations call the nominal diabetic surgery collectively “metabolic surgery”.