Non-alcoholic fatty liver disease (NAFLD) is a prevalent condition among diabetic adults, marked by excessive fat accumulation in the liver, and is closely linked to obesity, type 2 diabetes mellitus (T2DM), and metabolic syndrome. This study systematically reviews the role of physiotherapy interventions, including aerobic and resistance training, in reversing NAFLD among diabetic adults. A total of 20 studies were analyzed to evaluate the impact of structured exercise programs on hepatic health, glycemic control, and metabolic parameters. Results demonstrate that physiotherapy significantly reduces hepatic fat content, improves liver enzyme levels and enhances insulin sensitivity. Participants engaging in combined aerobic and resistance training showed notable improvements in fasting blood glucose, HbA1c levels, and anthropometric measures such as BMI and waist circumference. High-intensity interval training was found to amplify benefits, particularly in fat oxidation and lipid profiles. When combined with dietary modifications, physiotherapy achieved superior outcomes, underscoring the effectiveness of a multidisciplinary lifestyle approach.This article literature supports the integration of physiotherapy as a cost-effective, non-pharmacological strategy for managing NAFLD in diabetic adults, with significant implications for liver and metabolic health.