Schizophrenia is a serious mental disorder characterized by cognitive impairment as one of its core symptoms. Metabolic complications such as abdominal obesity are widespread in patients with schizophrenia. This not only elevates the risk of cardiovascular disease in patients， but is also associated with cognitive deficits， particularly impairments in attention， memory， and executive function. Studies have shown that combined abdominal obesity in schizophrenia may affect cognitive function through multiple mechanisms， such as triggering chronic inflammatory responses， insulin resistance， and influencing the composition of the gut flora， which may further exacerbate cognitive impairment. This article describes the risk factors for combined abdominal obesity in schizophrenia， as well as the potential mechanisms and treatment strategies affecting cognitive impairment， and looks forward to future research directions， with a view to providing a theoretical basis for improving abdominal obesity and cognitive impairment in schizophrenia.