Objective: To investigate the effect of Freudian psychoanalytic therapy on disease uncertainty and anxiety in patients with type 2 diabetes undergoing metabolic surgery. Methods: Thirty patients with type 2 diabetes treated by metabolic surgery in Department of General Surgery of Beijing Tiantan Hospital from March to December 2017 were selected as a control group, and routine nursing was performed. Thirty patients with type 2 diabetes treated by metabolic surgery in the same department from January to October 2018 were selected as an observation group, and Freudian psychoanalytic therapy was used on the basis of the control group. The clinical data were analyzed. Operative uncertainty, anxiety and nursing satisfaction were compared between the two groups. Results: After the intervention, the MUIs and SAS score of the observation group was significantly lower than those in the control group (all P<0.05). The satisfaction of surgical visit in safety requirements, professional quality and operation information needs of the observation group was higher than that of the control group (P<0.05). Conclusion: Freudian psychoanalytic therapy can increase the operation cognition of patients with type 2 diabetes mellitus metabolic surgery, reduce the uncertainty and anxiety, and improve the satisfaction of visiting.