Cagrilintide is a long-acting synthetic analog of the pancreatic hormone amylin, designed as a non-selective agonist for amylin receptors (composed of the calcitonin receptor and receptor activity-modifying proteins 1 or 3) and calcitonin receptors, which mediates its effects on energy homeostasis and glucose regulation in preclinical and early clinical models. By binding to these receptors in the central nervous system and periphery, cagrilintide suppresses postprandial glucagon secretion, slows gastric emptying, and promotes satiety through brainstem-mediated pathways, thereby reducing caloric intake and supporting weight loss in rodent models and phase 1/2 human trials for obesity and type 2 diabetes. Its extended half-life, achieved via structural modifications to minimize amyloid fibril formation inherent to native amylin, enables once-weekly subcutaneous administration, distinguishing it from shorter-acting analogs like pramlintide. Ongoing phase 3 trials, including combinations with GLP-1 receptor agonists like semaglutide (as CagriSema), demonstrate superior body weight reductions of up to 20% over 68 weeks compared to monotherapies, underscoring its potential as a multi-target incretin mimetic, though long-term safety and efficacy in diverse populations require further validation.