Purpose: This study aimed to explore the perceptions of exercise among adults with type 2 diabetes (T2DM, all type 2 diabetes in this article will be replaced by T2DM) and identify barriers and facilitators influencing their exercise behaviors. Despite the well-documented benefits of exercise in managing T2DM, many patients fail to incorporate physical activity into their routines, highlighting the need to understand their perspectives.Methods: A descriptive literature review was conducted, analyzing 10 qualitative studies published between 2014 and 2024. Databases including PubMed and CINAHL were searched using terms such as "type 2 diabetes," "exercise," "adult," and "qualitative." Selection criteria focused on studies examining T2DM patients’ exercise-related attitudes, motivations, and challenges. Thematic analysis was applied to synthesize findings, guided by Roy’s Adaptation Model.Results: Two overarching themes emerged: external support and self-factors. Key external barriers included inadequate community infrastructure (e.g., unsafe or inaccessible exercise environments), insufficient social/familial support, and limited guidance from healthcare professionals. Self-related barriers encompassed physical limitations (e.g., pain, fatigue), low motivation, psychological stress, time constraints, and knowledge gaps about diabetes management. Facilitators included family encouragement, peer support, access to professional coaching, and tailored exercise education.Conclusions: Addressing both systemic (e.g., infrastructure improvements, multidisciplinary care) and individual (e.g., personalized motivation strategies, education) barriers is critical to enhancing exercise adherence in adults with T2DM. Healthcare providers should adopt holistic, culturally sensitive approaches to empower patients and improve long-term health outcomes.