The results showed that, after treatment with sEVs, the expression of TNF-α in nerve tissues was reduced, and the levels of TGF-β, IL-10, and Arg1 increased, indicating that exosome treatment reversed the increase in M1 type macrophages and the decrease in M2 type macrophages caused by diabetes, which is achieved by the polarization of macrophages M2 to reduce inflammation and improve neurovascular function. Here, TNF is linked to diabetes mellitus.