Background: Type 2 Diabetes Mellitus is one of the most prevalent health problems worldwide. It is associated with physical disabilities, low physical fitness levels, and psychological problems as depression and anxiety. Aim: Determine the effect of combined exercises program on physical fitness, anxiety and depression among older adults with type 2 diabetes mellitus. Method: A quasi-experimental (pre and post intervention) design. This study was conducted in geriatric outpatient clinic in Specialized Medical Hospital, Mansoura University, and involved a purposive sample of 61 older adults diagnosed with type 2 diabetes mellitus. Tools: Mini-Mental State Examination, Demographic and Clinical Data Structured Interview Sheet, Physical Fitness Tests, Generalized Anxiety Disorder Questionnaire, and Geriatric Depression Scale Short Form. Results: This study indicates 52.5% of the participants were males. There was a statistically significant improvement of physical fitness tests, anxiety and depression, particularly among young elderly males, who were married, with higher education, had enough income, and who were living with their families. Also a statistically negative correlation was found between the mean score of anxiety and depression of the studied older adults and physical fitness tests. Conclusion: Combined exercises program proved to be effective in improving physical fitness and it was successful in decreasing anxiety, and depression among elderly patients with type 2 diabetes. Recommendation: Regular exercises should be recommended for diabetic elderly patients in order to improve their physical fitness, alleviate anxiety and overcome depression.