Objective: To study the effect of resistance + aerobic exercise on insulin resistance, plaque properties and lipid metabolism in patients with diabetic macroangiopathy. Methods: Patients with type 2 diabetes mellitus complicated by macroangiopathy who were treated in Zigong Third People’s Hospital between February 2015 and April 2016 were selected as the research subjects and randomly divided into exercise group and the control group who received resistance + aerobic exercise combined with hypoglycemic therapy and routine hypoglycemic therapy respectively. The insulin resistance indexes, plaque property indexes and lipid metabolism indexes were detected before intervention and 16 weeks after intervention. Results: 16 weeks after inclusion, serum F-Ins, MCP-1, YKL-40, MMP9, CatK, Caspase-3, TG, LDL, Resistin, Leptin and Visfatin contents of both groups of patients were significantly lower than those before inclusion, and serum F-Ins, MCP-1, YKL-40, MMP9, CatK, Caspase-3, TG, LDL, Resistin, Leptin and Visfatin contents of exercise group were significantly lower than those of control group. Conclusion: Resistance + aerobic exercise can improve the insulin resistance and lipid metabolism and stabilize the plaque properties in patients with diabetic macroangiopathy.