In view of the differences between our patients and those in Europe and the United States, we have developed a consensus on the indications for surgical treatment of diabetes mellitus in China. For type 1 diabetes, gestational diabetes, or other special types of diabetes, internal medicine is the treatment of choice; 2. All patients with a clear diagnosis of type 2 diabetes and a BMI ≥ 28, who have poor results or cannot tolerate after standard non-surgical treatment, can be considered for surgery as long as there are no obvious contraindications to surgery; 3. (1) patient’s age ≤ 60 years; (2) patient’s duration of T2DM ≤ 15 years; (3) patient’s islet reserve function is more than 1/2 of the lower limit of normal, and C peptide ≥ 1/2 of the lower limit of normal. If the patient does not have the above conditions, systemic medical treatment can be performed first, and if the effect of medical treatment is not good and the patient strongly requests, surgical treatment can be tried under the premise of fully informing the patient. If the patient has the above conditions, surgery should be the first choice of treatment for patients with BMI ≥ 32; if the BMI is between 28 and 32, and the patient has no obvious comorbidities and waist circumference < 90 cm for men or < 80 cm for women, medical treatment should be given priority, but surgery can be used as an alternative treatment when medical treatment is not effective; if the BMI is between 28 and 32, but the patient has significant other metabolic comorbidities, surgery can be used as an alternative treatment. If the BMI is between 28 and 32, but the patient has obvious other metabolic disorders (such as hypertension, hyperlipidemia, etc.) or obvious risk factors (especially cardiovascular risk factors), especially when the waist circumference is ≥90 cm in men or ≥80 cm in women, surgical treatment is recommended.