SGLT2i was significantly superior to INS (OR: 0.75, 95% CI 0.62–0.91), DPP4i (OR: 0.68, 95% CI 0.59–0.78), GLP1a (OR: 0.65, 95% CI 0.54–0.78), and TZD (OR: 0.46, 95% CI 0.27–0.77) in terms of heart failure risk. Here, INS is linked to heart failure.