Abstract / Summary
Abstract Background Acupuncture has demonstrated distinct clinical efficacy in the intervention of diabetic obesity. This study systematically assessed the methodological and reporting quality of clinical trials and meta-analyses concerning acupuncture therapy for diabetic obesity, aiming to identify prevalent limitations and propose corresponding optimization strategies. Methods Seven major databases were searched for clinical trials and meta-analyses on acupuncture therapy for diabetic obesity from their inception to 24 July 2025.For clinical trials, the Standards for the Reporting Interventions in Clinical Trials of Acupuncture (STRICTA) 2010 checklist, the Consolidated Standards of Reporting Trials (CONSORT) 2025 statement and the Transparent Reporting of Evaluations with Nonrandomized Designs (TREND) statement were adopted to assess reporting quality, while the Methodological Index for Non-Randomized Studies (MINORS) criteria, the Cochrane Risk of Bias tool version 2 (RoB 2.0) and the Risk Of Bias In Non-randomized Studies - of Interventions (ROBINS-I V2) 2025 tool were used to evaluate methodological quality. For meta-analyses, A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR 2) was applied to evaluate methodological quality, the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) 2020 guidelines for reporting quality, and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system to assess the certainty of evidence.Multidimensional analyses were conducted to characterize the overall status of methodological, reporting and evidence quality within this field. Results A total of 109 studies were included, comprising 81 randomized controlled trials, 25 non-randomized studies of interventions, and 3 meta-analyses.Overall, both the reporting and methodological quality of studies in this field require substantial improvement.Among the six assessment tools for clinical trials, compliance was relatively high only for the STRICTA 2010 checklist and MINORS criteria; compliance related to open science practices, randomization procedures and blinding implementation was the lowest.In addition, meta-analyses obtained relatively high scores only in PRISMA 2020 guidelines-assessed reporting quality, with severe omissions regarding publication bias reporting, heterogeneity exploration and sensitivity analyses. Conclusions Existing clinical trials and meta-analyses of acupuncture for diabetic obesity fail to meet standard criteria in methodological design and the reporting of core items.Future studies should strictly adhere to internationally recognized reporting guidelines and carry out multi-stage self-assessment together with iterative protocol refinement.