The Global Burden of Disease Study highlights diabetes’ substantial impact, contributing to health disasters, such as amputations of limbs, blindness, and severe cognitive impairments. Diabetes, with its elevated glucose levels, can lead to human health catastrophe in an aging population with an increasing risk of Alzheimer’s disease and related dementias (AD/ADRD). Leveraging advancements in big data neuroimaging, cloud computing, and the Internet of Things, the chapter proposes a digital twin model for monitoring vascular brain health using functional near-infrared spectroscopy (fNIRS) while exergaming (gaming technology-driven physical activities) in home settings. Here, fNIRS-based modal analysis serves as a foundation for developing digital twin models, offering a precise framework for monitoring vascular cognitive health. This technology innovation can empower clinicians and caregivers to implement timely interventions, potentially preventing or delaying neurovascular dysfunction in T2DM and progression to AD/ADRD.