Abstract: Objective To investigate the efficacy of conbercept in the treatment of different types of diabetic macular edema (DME) and its effects on visual acuity and retinal thickness. Methods A prospective study was conducted on 309 DME patients enrolled at Mianyang Wanjiang Eye Hospital from January 2024 to January 2025. Propensity score matching was employed for selection. All patients underwent optical coherence tomography (OCT) examination. Based on OCT findings, patients were classified into serous retinal detachment (SRD) type, cystoid macular edema (CME) type, and diffuse retinal thickening (DRT) type, with 103 cases in each group. The clinical efficacy, best corrected visual acuity (BCVA), central retinal thickness (CRT), fundus blood flow, and incidence of complications were compared among the three groups. Results After 9 weeks of treatment, significant differences in clinical efficacy were observed among the three groups (two-sided P＜0.05). The DRT type was significantly superior to the CME and SRD types (two-sided P＜0.05), and the CME type was significantly superior to the SRD type (two-sided P＜0.05). At 3, 6, and 9 weeks of treatment, significant differences in the logarithm of the minimum angle of resolution (logMAR) BCVA were found among the three groups (two-sided P＜0.05). The DRT type was significantly lower than the CME and SRD types (two-sided P＜ 0.05), and the CME type was significantly lower than the SRD type (two-sided P＜ 0.05). Similarly, at 3, 6, and 9 weeks of treatment, significant differences in CRT were observed among the three groups (two-sided P＜0.05). The DRT type was significantly thinner than the CME and SRD types (two-sided P＜0.05), and the CME type was significantly thinner than the SRD type (two-sided P＜0.05). After 9 weeks of treatment, significant differences in deep capillary plexus (DCP) and superficial capillary plexus (SCP) vessel density were noted among the three groups (two-sided P＜0.05). The SCP vessel density in the DRT type was lower than that in the CME and SRD types, and the DCP vessel density in the DRT type was lower than that in the SRD type (two-sided P＜0.05). The total incidence of complications also showed significant differences among the three groups (two-sided P＜0.05), with the DRT type being significantly lower than the CME and SRD types (two-sided P＜0.05), and the CME type being significantly lower than the SRD type (two-sided P＜0.05). Conclusion The efficacy of conbercept in treating different types of DME shows significant differences in clinical outcomes, BCVA, CRT, fundus blood flow, and complication rates. The DRT type demonstrates a more favorable response to treatment compared to the CME and SRD types.