The in vivo transplantation of the G-ADSC-Exos promoted the angiogenesis and blood perfusion and protected the muscle in the T2DM mouse limb ischemia model, and the probable underlying mechanisms were the activation of eNOS/AKT/ERK/P-38 signaling pathways, inhibition of AP-1/ROS/NLRP3/ASC/Caspase-1/IL-1β, as well as increased secretion of VEGF, IGF-1, and FGF. This evidence concerns the gene AKT1 and limb ischemia.