To increase the benefits of three-dimensional exercise games, the steps to develop these games need to be effective and efficient. The purpose of this study is to determine the game development model used in the design of three-dimensional games for exercise to create effective, efficient, usable, and safe games for users. In this article, studies on exercise programs and game development models in the literature were examined. According to the results from the literature, the considerations which should be taken into account when designing the three-dimensional exercise games are: creating user-specific exercise training programs, having game and gamification elements, providing expert support in determining an exercise program, having rich tools for measuring and evaluating physical activities, providing feedback about short and long term user performance, and that it can be used independently in the home environment. [Note: The year (2019) shown on the PDF is incorrect. The correct year is 2021.]