Phlorotannins, phenolic compounds found in brown macroalgae, exhibit potential bioactive effects. This study evaluated the extraction of phlorotannins from Fucus vesiculosus using conventional and ultrasound-assisted extraction (UAE) methods, focusing on solvent-material ratio, solvent concentration, extraction time, and sonication power for UAE. The experiments, designed using a Box-Behnken design, measured total phlorotannin content (TPhC), DPPH, FRAP, and ABTS. The conventional method, under optimal conditions, produced TPhC, DPPH, FRAP, and ABTS values of 512.25 ± 14.26 mg PGE/100 g, 29.70 ± 1.40 mg TE/100 g, 589.57 ± 15.06 mg TE/100 g, and 332.73 ± 31.03 mg TE/100 g, respectively. The UAE method, under its optimal conditions, yielded higher values: 954.00 ± 33.65 mg PGE/100 g, 146.35 ± 3.30 mg TE/100 g, 1037.61 ± 32.93 mg TE/100 g, and 809.95 ± 46.58 mg TE/100 g. The extracts were tested for inhibitory effects on α-amylase and α-glucosidase, with the purified UAE extract showing greater inhibition of α-amylase (IC50 = 7.06 ± 0.67 μg/mL) compared to acarbose (IC50 = 14.63 ± 0.28 μg/mL). For α-glucosidase, acarbose had higher activity (IC50 = 11.54 ± 0.04 μg/mL) than the UAE purified extract (IC50 = 15.04 ± 0.07 μg/mL). UHPLC-qTOF-MS analysis identified various phlorotannin derivatives, with Tetrafucotetraphlorethol (m/z 993) only in the UAE purified extract. This study concludes that purified phlorotannin extract from UAE can potentially regulate α-amylase and α-glucosidase, enzymes linked to metabolic disorders like diabetes and obesity.