Based on the management data of patients with type 2 diabetes in Tianchang City in 2023，this study selected 519 patients aged 35 and above who were newly included in the management of patients with type 2 diabetes in Tianchang City in the first quarter of 2023 as research subjects，and used propensity score matching to study the effect of free medication on the follow - up effect of patients with type 2 diabetes. The results showed that the average treatment effect of free medication on glycemic control，medication compliance， psychological adjustment，and medical compliance in patients with type 2 diabetes mellitus in Tianchang City were 0.064，- 0.338，- 0.293 and-0.358，respectively，with positive effects and significant effects. Overall， actively encouraging free medication can help promote the health management of patients with type 2 diabetes in Tianchang City. In a certain extent，free medication can play a positive role in improving the medication compliance of these patients with type 2 diabetes in Tianchang City，as well as in improving their psychological adjustment and medical compliance behavior.