ObjectiveTo systematically review the intervention efficacy of resistance exercise on prediabetes and type 2 diabetes. MethodsPubMed, The Cochrane Library, EMbase, Web of Science, EBSCO, VIP, WanFang Data and CNKI databases were electronically searched to collect randomized controlled trials (RCTs) of resistance exercise applied to pre-diabetic and type 2 diabetic population from 2010 to April, 2021. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Meta-analysis was then performed using Revman 5.1 and Stata 12.0 software. ResultsA total of 26 RCTs involving 2 078 patients were included. The results of meta-analysis showed that resistance exercise could improve fasting blood glucose (MD=−0.57, 95%CI −0.69 to −0.45, P<0.000 01), glycosylated hemoglobin (MD=−0.28, 95%CI −0.33 to −0.22, P<0.000 01), high density lipoprotein (MD=0.06, 95%CI 0.01 to 0.11, P=0.01), low density lipoprotein (MD=−0.35, 95%CI −0.47 to −0.24 , P<0.000 01), total cholesterol (MD=−0.25, 95%CI −0.39 to −0.12, P=0.000 3), steady-state model-insulin resistance index (MD=−0.74, 95%CI −0.80 to −0.68, P<0.000 01), and body mass index (MD=−0.54, 95%CI −1.03 to −0.05, P=0.03) compared with control group. ConclusionsResistance exercise can improve the blood glucose, blood lipid, and insulin resistance levels of individuals with abnormal glucose and lipid metabolism. Due to limited quality and quantity of the included studies, more high-quality studies are required to verify above conclusions.