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Another protective mechanism exerted by exenatide on the endothelium is through its action through opening the KATP channels thus protecting against impairment in endothelium-dependent vasodilatation induced by ischemiareperfusion (IR) injury [64]

That's what semaglutide can do

They are changing the signaling around hunger, satiety, and meal response

Moutan Cortex polysaccharide ameliorates diabetic kidney disease via modulating gut microbiota dynamically in rats

But the results you see on forums ('10kg lean mass in 6 weeks') are either exaggerated, achieved with stacked compounds, or represent water retention misinterpreted as muscle growth