Through a series of analyses, including prediction of downstream targets of miR-135a-3p, construction of miR-135a-3p-regulated mRNA network relationship maps, GO and KEGG enrichment analysis, PPI network analysis, and luciferase experiments, we found that exosomes from peripheral blood carry miR-135a-3p into HVSMCs, which may target and inhibit ATM, activate the ErbB signaling pathway, and promote abnormal proliferation and migration of HVSMCs, leading to T2D vascular injury. The gene discussed is ATM; the disease is type 2 diabetes mellitus.