Aims: To map physiotherapy, exercise and physical-modality interventions for erectile dysfunction (ED) in adults with diabetes mellitus and/or hypertension, characterize intervention and outcome patterns and identify rehabilitation evidence gaps. Study design: Scoping review. Place and Duration of Study: Evidence sources were searched internationally during August 2026, with a final citation and eligibility audit completed on 2 September 2026. Methodology: A Joanna Briggs Institute-informed scoping review was reported according to the PRISMA extension for Scoping Reviews (PRISMA-ScR). PubMed/MEDLINE, CENTRAL, PEDro, African Journals Online, Google Scholar, ClinicalTrials.gov and WHO ICTRP yielded 921 records; 799 unique records were screened. Mixed cohorts were eligible when diabetes/hypertension findings were separately extractable or the target population comprised at least 50% of participants. Study-family linking prevented double counting. Findings were synthesized descriptively without meta-analysis or formal risk-of-bias appraisal. Results: Forty-four sources representing 41 independent study families were included; 37 had outcome data and four were registry-only. Low-intensity extracorporeal shockwave therapy (Li-ESWT) dominated the map (24/41 families), followed by exercise/lifestyle interventions (7/41). Diabetic studies reported both favourable and null findings; severe or uncontrolled diabetes was repeatedly associated with attenuated shockwave response or durability, whereas hypertension showed less consistent modifier effects. Exercise/lifestyle findings were generally favourable. Pelvic-floor muscle training (PFMT), electrical stimulation, manual therapy and other modalities were sparsely studied. Only two Nigerian families were identified. Conclusion: Rehabilitation and physical interventions are being studied across cardiometabolic ED, but evidence is uneven and dominated by heterogeneous shockwave protocols. Exercise and PFMT warrant larger comparative trials, standardized intervention reporting and longer follow-up. The evidence supports a complementary multidisciplinary rehabilitation role rather than a uniform efficacy claim.