Study sample included 40 150 adults with incident type 2 diabetes between 2014 and 2022. Utilization of sodium–glucose cotransporter 2 inhibitors and glucagon-like peptide 1 receptor agonists has rapidly increased with the evolution of guidelines that emphasize cardio-kidney-metabolic risk reduction. Insulin, sulfonylurea, and DPP-4 inhibitor use has declined. Usage of metformin and thiazolidinediones remained stable.