Two distinct subtypes of treatment-resistant schizophrenia (TRS) area unit recently reported, further as earlytreatment resistance (E-TR) and late-treatment resistance (L-TR). This study was to assess clozapine-induced metformin-resistant prediabetes/diabetes and its correlation with clinical effectiveness in schizophrenia E-TR subtype. The incidence of clozapine-induced metformin-resistant prediabetes/diabetes was considerably high in schizophrenia early-treatment resistance (E-TR) subtype. Clozapine-induced metformin-resistantprediabetes/ diabetes represented degree freelance risk issue that adversely affected the clinical effectiveness of tranquilizer for schizophrenia E-TR subtype. Switch to tranquilizer strategy need to be reconsidered at intervals the treatment of patients with schizophrenia E-TR subtype. Given the high incidence of metformin-resistant clozapine-induced prediabetes/diabetes, the viability of manner interventions to prevent clozapine-induced prediabetes/diabetes in patients with schizophrenia E-TR subtype need to be assessed in future studies.