This report investigates the efficacy of exenatide, a GLP-1 receptor agonist, in the treatment of type 2 diabetes mellitus (T2DM). The study, involving randomized and controlled populations in three phases (Duration-2, -3, and -4), compared exenatide's performance against conventional therapies like metformin, sitagliptin, pioglitazone, and insulin glargine. The research evaluated exenatide's impact on glycemic control, cardiovascular risk factors (blood pressure, body weight, HbA1c, and lipids), and the number needed to treat (NNT) to achieve recommended treatment goals. Findings indicated that exenatide, when used twice daily, improved glycemic control, reduced body weight, and lowered cardiovascular risks. The study highlighted exenatide's superiority in reducing HbA1c compared to sitagliptin and pioglitazone, with a significant absolute benefit increase (ABI) in meeting T2DM management goals, particularly regarding glycemic control and cardiovascular risk reduction. Although associated with adverse effects like nausea and diarrhea, exenatide demonstrated a favorable safety profile and effectiveness in the treatment of T2DM.