Compared with non-hypertension, non-hyperlipidemia, non-MetS, not using insulin participants, non-ASCVD, and non-CHF patients, hypertension, hyperlipidemia, MetS, using insulin, ASCVD, and CHF patients, had 1.523 times, 32.5%, 18%, 1.3 times, 1.11 times, and 2.468 times higher odds of DKD, respectively (all p< 0.05). Here, INS is linked to metabolic syndrome.