Objective To explore the application effect of motivational interview in exercise intervention for young and middle aged type 2 diabetes patients. Methods Eighty two young and middle-aged inpatients with type 2 diabetes were randomized into a control group and an intervention group by using a random number table, with 41 cases in each group. The control group was given routine exercise education and follow-up, while the intervention group received exercise education based on motivation interview. Exercise self-efficacy and exercise behavior stage indicators of the two groups were observed. Results The intervention group had significantly better improvements in exercise self-efficacy and exercise behavior stage indicators at 4 weeks after discharge（all P<0.05）.And at 12 weeks after discharge, the exercise self-efficacy, exercise behavior stage indicators, and blood glucose control indicators in the intervention group were significantly better than those in the control group (all P<0.05). Conclusion Exercise education based on motivation interview can improve the exercise self-efficacy and exercise compliance of young and middle aged patients with type 2 diabetes.