Objective To explore the effects of dapagliflozin and alogliptin on glucose fluctuation, insulin resistance, leptin and adiponectin in overweight/obese patients with type 2 diabetes mellitus (T2DM). Methods According to random number table method, 126 overweight/obese patients with T2DM were divided into dapagliflozin group (n=63) and alogliptin group (n=63) from January 2021 to December 2023. On basis of routine hypoglycemic treatment, dapagliflozin group was treated with dapagliflozin, while alogliptin group was treated with alogliptin. After 12 weeks of treatment, clinical curative effect, glucose fluctuation indexes ［mean of daily differences (MODD), mean amplitude of glycemic excursions (MAGE), largest amplitude of glycemic excursions (LAGE)］, insulin resistance indexes (islet β-cell function index, insulin resistance index, fasting insulin), leptin, adiponectin and occurrence of adverse reactions were compared between the two groups. Results There was no significant difference in clinical response rate between dapagliflozin group and alogliptin group (95.24% vs 92.06%, P＞0.05). After treatment, MODD, MAGE and LAGE were decreased in both groups, which were lower in dapagliflozin group (P＜0.05). After treatment, islet β-cell function index and adiponectin were increased, while insulin resistance index, fasting insulin, leptin and BMI were decreased in both groups (P＜0.05), but there was no significant difference in any index between the two groups (P＞0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P＞0.05).Conclusion Both dapagliflozin and alogliptin can effectively improve glucose fluctuation, insulin resistance, leptin and adiponectin levels in overweight/obese patients with T2DM. Dapagliflozin shows superior efficacy in reducing glucose fluctuation, and safety of the two is comparable