High density lipoprotein protects cardiovascular diseases and reduces the risk of cardiovascular diseases through cholesterol reverse transport and other mechanisms. High-density lipoprotein cholesterol (HDL-C) is an independent predictor of negative events in cardiovascular diseases. Low concentration of HDL-C indicates abnormal regulation of HDL anabolism. Various proteins and receptors such as cholesteryl ester transfer protein (CETP) are involved in HDL anabolism. Type 2 Diabetes Mullitu and its related metabolic syndrome, chronic inflammation as well as oxidative stress not only affect the proteins and receptors related to HDL anabolism, but also affect their functional changes, making HDL change from anti-inflammatory, antioxidant, protecting endothelial cell function to pro-inflammatory, pro-oxidative and pro-endothelial cell apoptosis. This article will describe the relationship between HDL-C, type 2 diabetes and cardiovascular diseases from the effects of T2DM on HDL anabolism and function, and further explore the effectiveness of elevating HDL-C in treating cardiovascular diseases of patients with type 2 diabetes.