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Background Type 2 diabetes mellitus (T2DM) is a prevalent metabolic disorder often associated with obesity. Despite conventional management strategies, many patients fail to achieve sustained remission. Objective This study aimed to investigate the role of metabolic bariatric surgery (MBS), specifically Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG), in achieving remission of T2DM and evaluating the effects on glycemic control and overall metabolic health in patients with obesity. Methods This retrospective study was conducted at Shalamar Hospital, Lahore, Pakistan from January 2021 to December 2024. Data for this study were collected from electronic medical records. It included glycated hemoglobin (HbA1c) levels at baseline and subsequent intervals of three, six, and 12 months. Comparative analyses between the RYGB and SG groups were performed. Fasting blood glucose levels, use of antidiabetic medications (including both oral hypoglycemic agents and insulin), and anthropometric measurements such as weight and BMI were also tracked over time. To identify independent predictors of complete diabetes remission at 12 months, multivariate logistic regression analysis was performed. Results were reported as ORs with 95% CIs and Wald chi-square statistics. A p-value of <0.05 was considered statistically significant for all tests. Results At baseline, the mean age was 47.2 years, and the mean BMI was 42.6 kg/m². At three months, 38 of 81 (46.9%) patients achieved early glycemic response of T2DM. At six months, 21 of 81 (25.9%) showed partial response. By 12 months, complete remission was observed in 29 of 81 patients (35.8%). RYGB patients had higher rates than SG patients at both three months (25/43 (58.1%) vs. 13/38 (34.2%)) and 12 months (20/43 (46.5%) vs. 9/38 (23.7%)). Conclusions MBS, particularly RYGB, offers a highly effective treatment for T2DM in patients with obesity, with significant and sustained improvements in glycemic control and metabolic health. Early intervention, particularly in patients with shorter diabetes duration and lower preoperative HbA1c, maximizes the likelihood of achieving remission.