Where paleo lands on the metabolic spectrum
Short-term studies of paleo patterns typically report average improvements in body weight, waist circumference, blood pressure, fasting triglycerides, and glucose control (including HbA1c in some trials). The magnitude tends to sit between two reference points: smaller and broader than the sharp glucose and triglyceride shifts seen on strict keto, but clearly better than a baseline highly processed Western diet.
Much of the benefit is plausibly explained by what paleo removes (refined sugar and processed foods) and adds (more vegetables, protein, and fiber), rather than by the grain and legume exclusions specifically.
Reading averages against your own starting point
Before-and-after figures are group averages, and the size of any change depends heavily on the diet a person is leaving behind: someone shifting from a heavily processed diet will usually see more movement than someone already eating whole foods. Trials are also generally short, so durability over years is less certain.
This is general educational information, not medical advice. People on medication for blood pressure or glucose, or with kidney disease, should review any marked metabolic change with a qualified clinician rather than assume the direction is universally beneficial.