Metformin, a first-line clinical drug for treatment of T2DM, can significantly improve the osteogenic differentiation of BMSCs via the BMP-4/Smad/Runx2 signaling pathway, thereby compensating for the negative impact of BMP-4 deficiency on the functions of BMSCs from T2DM patients. The gene discussed is RUNX2; the disease is type 2 diabetes mellitus.