NOS3 and type 2 diabetes mellitus: These vascular abnormalities were further supported by ex vivo experiments, where plasma-derived small extracellular vesicles (EVs) from Y-T2D patients induced endothelial dysfunction in human coronary artery endothelial cells—marked by reduced phosphorylated eNOS expression, decreased nitric oxide production, elevated oxidative stress, and activation of inflammatory pathways.