BackgroundAvocado contains numerous vitamins, minerals, and phytochemicals that can contribute to reducing the risk of metabolic syndrome and diabetes. However, limited studies have examined the association between avocados and diabetes risk. ObjectiveThis study aimed to examine the association between avocado consumption and diabetes by sex in Mexican adults. DesignThis was a cross-sectional study. Participants/settingParticipants included a subsample of adults (aged 20 years and older) from the 2012, 2016, and 2018 Mexican National Health and Nutrition Survey. Avocado consumption was assessed using a 7-day, semiquantitative food frequency questionnaire, and participants were classified as avocado consumers (consuming any amount of avocado) or nonconsumers. Main outcome measuresParticipants were considered to have diabetes if they answered “yes” to “Has a doctor ever told that you have diabetes or high blood sugar?” Statistical analyses performedThis analysis assessed the association between avocado intake and diabetes using multivariate logistic models by sex and adjusted for relevant covariates. ResultsOf 28 239 Mexican National Health and Nutrition Survey 2012, 2016, and 2018 participants, 25 640 met the criteria (ie, have diabetes outcome and plausible energy and avocado intakes) for this study. More than half of the participants were women, and approximately 45% were avocado consumers, with an average (SE) avocado consumption of 34.7 (0.9) among men and 29.8 (0.8) g/day among women. Avocado consumers had lower odds of diabetes in both unadjusted (odds ratio [OR] 0.762, 95% CI 0.639 to 0.907) and adjusted (OR 0.792, 95% CI 0.632 to 0.993) models among women but not men (OR 1.192, 95% CI: 0.907 to 1.566 and OR 0.914, 95% CI 0.675 to 1.239 for unadjusted and adjusted models, respectively). ConclusionsAvocado consumption was associated with a lower risk of diabetes, which remained significant even when adjusted for relevant covariates. However, this finding was observed in only women, not men, underscoring the importance of personalized nutrition in diabetes care and prevention.