Type 2 diabetic osteoporosis (T2DOP) is a musculoskeletal system complication caused by type 2 diabetes (T2D), which is characterized by bone mass reduction, bone microstructure damage, bone strength reduction and increased fracture risk. T2DOP is asymptomatic in the early stage with complex pathogenesis and limited diagnostic methods. Patients have high disability and mortality rates. At present, T2DOP is mainly treated with anti-diabetic and anti-osteoporosis medications. In this review, the characteristics, pathogenesis, diagnosis and treatment of T2DOP were summarized, and the future direction of T2DOP treatment was discussed to reduce the bone fracture risk.