Background: Type II Diabetes Mellitus (Type II DM) is intricately linked with an increased risk of cognitive impairment and dementia. The ADIPOQ gene encodes adiponectin, a hormone that plays a critical role in glucose regulation and fatty acid oxidation and may be implicated in the pathophysiology of both diabetes and dementia. Understanding the expression of ADIPOQ in diabetic patients with dementia could offer insights into the mechanisms at play and aid in the development of potential therapeutic targets. Objective: This study aims to analyze the expression of the ADIPOQ gene in diabetic patients diagnosed with dementia and to correlate these findings with cognitive impairment as assessed by Mini-Mental State Examination (MMSE) scores. Methods: We collected 5ml EDTA blood samples from 88 diabetic dementia patients and 12 healthy controls after obtaining written informed consent. The study adhered to the Declaration of Helsinki guidelines. Serum adiponectin levels were measured via Chemiluminescent immunoassay (CLIA), and genomic DNA was isolated for methylation-specific PCR and expression analysis. ADIPOQ gene expression was quantified using real-time PCR, and data were analyzed using SPSS version 25, employing descriptive and inferential statistics. Results: The diabetic dementia patient group demonstrated significantly lower adiponectin levels (5.62 ± 1.08 µg/mL) and MMSE scores (10.68 ± 4.56) compared to healthy controls (adiponectin: 15.68 ± 4.64 µg/mL, MMSE: 25.9 ± 3.12). Real-time PCR results indicated a relative fold decrease of 4.9 in ADIPOQ gene expression in the dementia cohort. Conclusion: The ADIPOQ gene expression is inversely associated with cognitive function in diabetic patients, highlighting its potential as a biomarker for early detection and targeted therapeutic interventions in dementia associated with diabetes.