To analyze the burden of diabetes attributable to different risk categories and the trend of diabetes in China from 1990 to 2021, providing references for scientific prevention and treatment of diabetes.

Based on the global burden of disease data in 2021, we used Joinpoint regression to analyze the trends of diabetes deaths, disability adjusted life years (DALYs), and age-standardized mortality rate (ASMR) attributable to metabolic, behavioral, and environmental/occupational risks in China.

In 2021, the number of diabetes deaths attributable to metabolic, behavioral, and environmental/occupational risks in China increased to 178 400, 73 000, 45 900, and the ASMR decreased by 8.65%, 2.41%, and 8.37%, compared to 1990. The number of diabetes DALYs attributable to different risk categories were metabolic, behavioral, and environmental/occupational risks in descending order, and the rate of DALYs and ASDR showed an increasing trend.

The task of reducing the burden of diabetes disease in China remains daunting, and to intensify behavioral risks interventions for men and young people with diabetes.