Our observational cohort study investigated the association of HbA1c and weight changes with OW semaglutide in T2D and how such changes associated with OW semaglutide T2D compare with those associated with DPP-4 inhibitors. In the analyses, the index date was the date of the first prescription claim for OW semaglutide T2D. Pre- /post-index analyses showed in the OW semaglutide T2D cohort, 52.5% of patients achieved a post-index HbA1c <7.0%; 34.2% had weight loss ≥5.0%. After adjustment for imbalanced covariates, regression models indicated the odds of reaching specific HbA1c and weight loss goals were more than twice as great for the OW semaglutide T2D cohort than for the DPP-4 inhibitor cohort.