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Background Obesity and type 2 diabetes mellitus (T2DM) represent major and rapidly increasing public health burdens in Saudi Arabia. Metabolic (bariatric) surgery is an effective long-term intervention for obesity-related T2DM, while modern injectable pharmacotherapies, including glucagon-like peptide-1 receptor agonists, have become increasingly popular. However, public awareness and perceptions regarding these modalities remain insufficiently characterized in Saudi communities. Hence, this study aimed to assess public awareness, perceptions, misconceptions, and self-reported treatment preferences regarding metabolic (bariatric) surgery and injectable pharmacotherapies for obesity-related T2DM among adult residents of Jeddah, Saudi Arabia, using a perception-based cross-sectional survey. Methodology A community-based, descriptive, cross-sectional survey was conducted using an online, self-administered questionnaire distributed via social media platforms. The survey assessed sociodemographic characteristics, self-reported diabetes status, awareness and perceptions of obesity, metabolic (bariatric) surgery, and injectable pharmacotherapies, as well as stated treatment preferences. All outcomes reflect participant perceptions and were not intended to measure clinical knowledge or treatment effectiveness. Accordingly, type 2 diabetes status and related variables were self-reported and not verified through medical records. Descriptive statistics were used to summarize participant characteristics and awareness indicators. Chi-square tests were applied to explore exploratory associations between selected demographic variables and treatment preferences, with statistical significance set at a p-value <0.05. Results Participants demonstrated high awareness that obesity is a major modifiable risk factor for T2DM (74.6%). However, only 21.1% of participants recognized metabolic (bariatric) surgery as an effective metabolic intervention for diabetes improvement. Injectable therapies were preferred by 57.9% of participants, while 42.1% preferred surgical options. Misconceptions regarding indications, risks, and long-term outcomes were prevalent. Conclusions Although general awareness of obesity's metabolic impact was high, understanding of the therapeutic role of metabolic (bariatric) surgery for T2DM remained limited. Injectable therapies were more frequently preferred than surgical options; however, the present data do not allow definitive conclusions regarding the underlying drivers of these preferences. These findings highlight the need for structured public education initiatives to address misconceptions and improve metabolic literacy. The results reflect public perceptions rather than clinical decision-making or treatment effectiveness.