The incidence of type 2 diabetes in China is increasing annually, and its chronic complications are very common. Macrovascular complications are the main cause of death in patients with type 2 diabetes mellitus. The pathogenesis of diabetic macrovascular complications is different from that of traditional cardiovascular diseases. It has been found that macrovascular complications of type 2 diabetes are not only related to traditional cardiovascular disease risk factors (age, gender, hypertension, smoking, body mass index, diabetes duration, serum lipid, and glycosylated hemoglobin), but also diabetic microvascular complications, some specific molecular proteins and individual genetic background. This article reviews the clinical factors, molecular proteins and genetic background that affect the incidence of macrovascular complications in type 2 diabetes.