Objective To systematically evaluate the effectiveness of exercise therapy in diabetic foot ulcer (DFU) patients, and to provide evidence-based reference for developing exercise protocol. Methods We electronically searched Chinese and English databases for literature on the safety and efficacy of exercise therapy in DFU patients, from database inception to February 28, 2025. Two researchers independently screened the literature and extracted data. Meta-analysis was performed using RevMan 5.4 software. Results A total of 14 studies involving 1,040 diabetic foot patients were included. Meta-analysis results showed that, compared with usual care, exercise therapy significantly improved the wound healing rate［OR=2.72, 95%CI(1.71, 4.33)］, achieved a greater reduction in wound area ［MD=5.43, 95%CI(2.94, 7.92)］, and enhanced the ankle-brachial index ［MD=0.06, 95%CI(0.04, 0.09)］ and transcutaneous oxygen pressure (TcPO2) values ［MD=5.03, 95%CI(3.25, 6.81)］. However, there was no statistically significant difference in the incidence of adverse events between groups ［RR=0.54, 95%CI(0.23, 1.31)］. Conclusion Exercise therapy can improve the wound healing rate, reduce wound area, and enhance ankle-brachial index and transcutaneous oxygen pressure in DFU patients. Nevertheless, more high-quality and large sample studies are needed to confirm these findings.