Metabolic syndrome (MS) is characterized by the coexistence of metabolic disturbances such as insulin resistance, central obesity, dyslipidemia, and hypertension, which significantly increase the risk of cardiovascular diseases and type 2 diabetes. Physical training plays a central role in the prevention and treatment of MS by promoting physiological adaptations and widely documented clinical benefits. Evidence shows that aerobic exercise improves insulin sensitivity, endothelial function, and lipid profile, while resistance training contributes to increased lean mass, higher basal energy expenditure, and reduced visceral adiposity. Combined protocols (aerobic + resistance) produce superior synergistic effects on body composition and systemic inflammatory markers. Physiological mechanisms include increased mitochondrial biogenesis, reduced oxidative stress, regulation of adipokines, and improved peripheral glucose uptake mediated by GLUT-4. Clinically, structured exercise programs performed at least three times per week, at moderate to vigorous intensity, are effective in reversing syndrome components and reducing overall cardiovascular risk. Thus, physical training represents a highly relevant non-pharmacological intervention in the integrated management of metabolic syndrome, with a positive impact on metabolic physiology and patients’ quality of life.
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