Diabetic osteoporosis (DOP), as a typical representative of metabolic-immune cross-talk imbalance, has an unclear pathogenesis and lacks effective targeted intervention methods. This study aims to systematically analyze the molecular mechanism by which fecal microbiota transplantation (FMT) activates the TGF-β signaling axis through MOESIN lactic acid modification, reshapes the Treg/Th17 immune balance, and improves the pathological process of DOP based on multi-omics integrated analysis