Background: Type2 diabetes (T2D) is a global health problem, which increases the risk ofcardiovascular disease (CVD). Aerobic capacity is lower in T2D individuals compared tohealthy, and women with T2D have even lower aerobic capacity compared to men with T2D.These sex disparities could lead to increased CV morbidity and mortality in womencompared with men with T2D. However, the same exercise recommendations are given towomen and men.Objectives: To compare the cardiometabolic training response in women and men with T2Dfollowing the same exercise interventions. We hypothesized that women with T2D wouldhave a reduced exercise response compared to men.Methods: Twenty-nine individuals with T2D (15 women, 14 men), were randomized andstratified by sex to either supervised training group (STG) or active control group (ACG) for12 weeks. The STG performed aerobic and resistance training three days a week, whereasthe ACG was advised to use a Mio Slice heart rate watch and reach 100 PAI (Personalactivity intelligence) each week. Changes in cardiac function, glycosylated hemoglobin(HbA1c), insulin resistance, aerobic capacity (VO2peak) and heart rate recovery weremeasured.Results: Both STG and ACG showed significant improvements in cardiac function andaerobic capacity with no significant difference between groups. In the STG, men improvedmore than women in VO2peak (25%, p < 0.001 vs. 15%, p = 0.001) and stroke volume index(15%, p = 0.10 vs. 11%, p = 0.04). Whereas, only women significantly improved heart raterecovery (after 1min, 48%, p = 0.04), insulin resistance (25%, p = 0.03), insulin C-peptide(27%, p = 0.02) and right ventricular systolic function (TAPSE, 21%, p=0.04). Both sexesin the ACG showed improvements in cardiac function and aerobic capacity.Conclusions: Women had less improvement in left ventricular cardiac function and aerobiccapacity compared to men after 3 months of supervised training. However, women had agreater response in insulin resistance and heart rate recovery. Moreover, a weekly activityindex PAI can be an effective strategy to motivate and increase the exercise adherence forboth women and men. Further research is needed to investigate the sex differences intraining response to potentially develop sex specific training programs to optimize theeffects of training.