ObjectiveThis study aimed to investigate the acute effects of aerobic exercise (AE), resistance exercise (RE), and integrated concurrent exercise (ICE; i.e., AE plus RE) on executive function among hospitalized type 2 diabetes mellitus (T2DM) inpatients, and the mechanism of cerebral hemodynamics.MethodsA within-subject design was applied in 30 hospitalized patients with T2DM aged between 45 and 70 years in the Jiangsu Geriatric Hospital, China. The participants were asked to take AE, RE, and ICE for 3 days at 48-h intervals. Three executive function (EF) tests, namely, Stroop, More-odd shifting, and 2-back tests, were applied at baseline and after each exercise. The functional near-infrared spectroscopy brain function imaging system was used to collect cerebral hemodynamic data. The one-way repeated measurement ANOVA was used to explore training effects on each test indicator.ResultsCompared with the baseline data, the EF indicators have been improved after both ICE and RE (p< 0.05). Compared with the AE group, the ICE and RE groups have demonstrated significant improvements in inhibition (ICE: MD = − 162.92 ms; RE: MD = −106.86 ms) and conversion functions (ICE: MD = −111.79 ms; RE: MD = −86.95 ms). Based on the cerebral hemodynamic data, the beta values of brain activation in executive function related brain regions increased after three kinds of exercise, the EF improvements after the ICE showed synchronous activation of blood flow in the dorsolateral prefrontal cortex (DLPFC), the frontal polar (FPA) and orbitofrontal cortex (OFC), the improvement of inhibitory function after RE displayed synchronous activation of DLPFC and FPA, and AE mainly activates DLPFC. The HbO2concentration in the pars triangularis Broca's area increased significantly after AE, but the EF did not improve significantly.ConclusionThe ICE is preferred for the improvements of executive function in T2DM patients, while AE is more conducive to the improvements of refresh function. Moreover, a synergistic mechanism exists between cognitive function and blood flow activation in specific brain regions.