One of the complications of type 2 diabetes mellitus in men is steroidogenic and spermatogenic dysfunctions. There is evidence of a restoring effect of the antidiabetic drug metformin on them. We studied the effect of MF therapy (4 weeks, 200 mg/kg/day) on the hormonal parameters of the gonad axis and on the morphological characteristics of epididymal spermatozoa in male rats with a severe form of T2DM caused by a high-fat diet and a low-dose streptozotocin. It has been shown that MF therapy, along with the restoration of the metabolic parameters, normalizes the plasma levels of testosterone and leptin and the content of testosterone, its precursors, leptin and its receptors in the testes, and also increases sperm motility, which is reduced in T2DM. This is the result of both the systemic action of MF and its direct effect on testicular cells.