Metabolic surgery is a serious option to treat type 2 diabetes. The latest guidelines consider surgery as one of the first option, especially in patients suffering from severe obesity or those who have uncontrolled diabetes. However, the radicality of metabolic surgery limits its prescription and is difficult to handle. Indeed, criteria of success remain insufficently understood in order to help caregivers to rigorously select the right candidates. This article proposes a review of the literature on the risks and benefits of metabolic surgery for the diabetic obese patient.