Objective To observe the short-term effects of laparoscopic sleeve gastrectomy on glucose and lipid metabolism disorders in obese patients with diabetes and non-alcoholic fatty liver disease. Methods A retrospective analysis was conducted on 130 patients who underwent laparoscopic sleeve gastrectomy from January 2020 to December 2023. Based on the hospital's electronic medical record system, the patients were followed up for 6 months after surgery. Patient's preoperative and postoperative 3 and 6 months physical signs [body weight, body mass index （BMI）, and waist circumference], glucose metabolism indicators （glycated hemoglobin, fasting blood glucose, 2-hour postprandial blood glucose, pancreatic beta cell function index, and insulin resistance index）, blood lipids （total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and triglycerides）, and liver function indicators （aspartate aminotransferase, and alanine aminotransferase） were recorded and calculated. Results As of the last follow-up, 12 patients were lost to follow-up, and the remaining 118 patients successfully completed follow-up, with a follow-up rate of 90.77%. Patients' weight, BMI, waist circumference, glycated hemoglobin, fasting blood glucose, 2-hour postprandial blood glucose, pancreatic beta cell function index, insulin resistance index, total cholesterol, low-density lipoprotein cholesterol, triglycerides, aspartate aminotransferase, and alanine aminotransferase showed a decreasing trend over time after surgery, while high-density lipoprotein cholesterol showed an increasing trend. Compared with preoperative levels, there were statistically significant differences in physical signs, glucose metabolism, blood lipids, and liver function indicators at 3 and 6 months after surgery （P<0.05）. Postoperatively, a total of 7 patients developed incision infection and 1 patient developed abdominal infection, with an overall incidence of postoperative adverse events of 6.15% （8/130）. Conclusion Laparoscopic sleeve gastrectomy can help obese patients control their weight and improve blood glucose and lipid homeostasis.