For a very long time Type II was all a matter of insulin resistance at the cellular level. Metformin et al was supposed to mitigate that so a working pancreas could supply the needed insulin to the cells. All of a sudden and without explanation, apology or excuse it became a problem of not enough insulin being produced because the pancreas just gave up trying to get insulin into the cells. Why this change? Well, Ozempic et al stimulate that rusty old pancreas. Problem solved. A new problem with a solution in search of an answer?
Metformin as I understood it suppressed formation of glucose in the liver. Others they had me on stimulated the pancreas, to overwhelm the molecule that was causing the resistance. Some of those were wildly expensive (for my company insurance) and I don’t doubt wildly profitable.
Metformin, ironically, was almost as much a hindrance as a help. If I didn’t eat copiously after taking the stuff, I would be nauseated for hours. So much for dietary restriction.