AimsTo determine the prevalence and patterns of diabetes distress, and evaluate the differences in health outcomes between profiles. MethodsThis cross-sectional study included 330 adults with T2DM and overweight/obesity. The participants completed questionnaires on diabetes distress, sleep quality, self-efficacy, depression, anxiety and positive and negative affect. A cluster analysis was performed to identify different patterns of diabetes distress and one-way ANOVA was used to investigate the differences in physical and psychological outcomes between profiles. Results30.6% of patients were identified as moderately to highly distressed, with the regimen-related distress found to be the most prominent. The Cluster analysis revealed four distinct clusters: 1) “comprehensively exhausted profile”; 2) “strained profile”; 3) “high internal anguish profile”; 4) “unperturbed profile”. The measures of fasting blood glucose (FBG), glycated hemoglobin (HbA1c), low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, sleep quality, depression, anxiety, positive and negative affect and self-efficacy differ between clusters. ConclusionsThis study identified important differences that existed in patterns of diabetes distress among people with T2DM and overweight/obesity, and this variation can be utilized to tailor intervention strategies to the particular needs of different subgroups within individuals with T2DM.