This case describes a 44-year-old male with poorly controlled type 2 diabetes mellitus, dyslipidemia, and hypertension - hallmarks of metabolic syndrome - who demonstrated significant clinical improvement following the initiation of semaglutide, a glucagon-like peptide-1 receptor agonist (GLP-1 RA), after discontinuing sitagliptin. The gene discussed is GLP1R; the disease is Hypertension.