Effectiveness of Wearable Technologies in Supporting Physical Activity and Metabolic Health in Adults with Type 2 Diabetes: A Systematic–Narrative Hybrid Review

Background: Physical activity is essential in the prevention and management of type 2 diabetes mellitus (T2D), yet adherence to recommended activity levels remains insufficient. Wearable electronic devices have emerged as tools to support physical activity through self-monitoring and enhanced user engagement. This review synthesizes current evidence on the effectiveness of wearable technologies in improving adherence to physical activity and promoting clinical and metabolic health in adults with T2D. Methods: The review was conducted using systematic search strategies in PubMed and Scopus. We included studies that involved the use of wearable devices to monitor physical activity for at least seven consecutive days. The reported outcomes were related to physical activity adherence or clinical–metabolic health. Thirty-two studies met the inclusion criteria and were analyzed in terms of study design, device type, intervention characteristics, and outcomes. Results: Wearable devices were used either for monitoring daily activity in free-living conditions or within structured, often supervised, interventions. Most studies reported increased physical activity, particularly in step count. Several studies showed improvements in blood pressure and lipid profile, while results for HbA1c and BMI were mixed. Structured interventions with behavioural support produced more consistent and clinically relevant outcomes than passive monitoring alone. Conclusions: Wearable technologies can support physical activity in adults with T2D, especially when integrated into structured behavioural programmes. From a clinical standpoint, they may serve as useful tools to enhance lifestyle adherence, particularly when combined with professional support. Their inclusion in care pathways could help personalize interventions and improve long-term self-management.