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Metabolic syndrome (MetS) is a cluster of key clinical risk factors for cardiovascular disease (CVD) and type 2 diabetes mellitus (T2DM), making it essential to address its components through targeted lifestyle interventions, such as exercise. This study aimed to investigate the impact of a combined training (CT) programme on adult women diagnosed with MetS. We hypothesized that participating in the programme would improve glucose and lipid metabolism, cardiovascular health, functional fitness abilities (FFA), body composition and anthropometrics in women with MetS. 105 inactive women were randomly assigned to either a CT (n=84) or control group (n=21). The CT group performed supervised combined aerobic and resistance training 3 days/week for 6 months. Blood glucose, haemoglobin A1c (HbA1c), insulin levels, homeostatic model assessment for insulin resistance (HOMA-IR), lipid profile, mean arterial pressure (MAP), resting (r-HR) and maximal heart rate (max-HR), body composition, anthropometrics and FFA were assessed before and after 3 and 6 months of training. After 3 months, the CT group showed significant improvements compared to controls in blood glucose (-36.4%), HbA1c (-22.8%), HOMA-IR (-12.5%), MAP (-16.9%), max-HR (-5.3%), r-HR (-20.4%), skeletal muscle to fat ratio (MFR) (+37.5%), and FFA (+200%). At 6 months, benefits were sustained or enhanced, particularly in glycaemic regulation, cardiovascular parameters, MFR, and FFA levels (p < 0.05). MFR was positively and linearly associated with changes in FFA, cardiovascular function, and glycometabolic markers. A 24-week CT programme significantly improved key MetS parameters in women, suggesting that it may be an effective non-pharmacological strategy to reduce CVD and T2DM risk.