This meme is exactly what it sounds like. The original comic (aptly titled How To Talk To Short People) depicts disdain towards people who lean over patronizingly while talking to short people. While the image was doctored several times since its original upload in 2014, it wasn't until June of 2017 that it really became an exploitable meme format.
The current iteration of the meme revolves around ridiculous and violent ways to speak with the vertically challenged. Here are some choice examples.