Time is the key for evolutionary concepts here; abundant food (sugar), abundant sedentary lifecycle availability, abundant antibiotics / vaccines, -- are mostly still in their first generation of generational "study" -- in the developed world; ie an American born post World War 2.
And that's being generous, because the food industrialization (removal of fiber, concentration of sugars), and cultural norm of consistent fast food is much more in line with the tail end of millennials than any generation before.
Of course we're not seeing evolutionary pressures for diabetes, when, at the same time we've generally increased life expectancy past reproductive years.
Most basic factoid: Insulin was discovered in 1921 before Penicillin in 1928, before the Polio vaccine in 1950.