Objective: To analyze the efficacy of dagliflozin therapy and its effects on cardiac and renal function, glucose and lipid metabolism and bone metabolism in obese patients with type 2 diabetes mellitus (T2DM). Methods: 178 obese T2DM patients were admitted to Zhengzhou People's Hospital from January 2022 to July 2024, and the random number table was divided into control group (n=89, metformin treatment) and observation group (n=89, metformin combined with dagliflozin) for 6 months. Drug safety was assessed by comparing the changes in efficacy, body mass index (BMI), cardiac function, renal function, glucose and lipid metabolism, and bone metabolism indicators.] Results: The clinical efficacy in the observation group was higher than that in the control group (P <0.05). After treatment, BMI, lower, postprandial glucose (2h PG), glycated hemoglobin (HbAlc), total cholesterol (TC), triacylglycerol (TG) and low-density lipoprotein cholesterol (LDL-C) levels and higher high-density lipoprotein cholesterol (HDL-C) in the control group (P <0.05). Observation group had higher left ventricular ejection fraction (LVEF), and lower left ventricular end diastolic diameter (LVEDD) and blood uric acid (UA) than the control group (P <0.05). There was no difference in the levels of type I collagen amino acid extension peptide (PINP), β -collagen special sequences (β -CTX), and osteocalcin (OC) between the two groups (P> 0.05). There was no difference in the adverse effects between the two groups (P> 0.05). Conclusion: The use of dagliflozin in the treatment of obese T2DM patients is beneficial to improving clinical efficacy, improving glucose and lipid metabolism, protecting cardio-renal function, and has high safety, but it has no obvious effect on bone metabolism.