This study employed comprehensive multidimensional Mendelian randomization (MR) analyses to investigate potential causal associations between nine cathepsins (B, E, F, G, H, L2, O, S, and Z) and six diabetic chronic complications encompassing both microvascular (nephropathy, retinopathy, proliferative retinopathy, maculopathy, neuropathy) and macrovascular manifestations (peripheral angiopathy). The gene discussed is CTSS; the disease is retinal disorder.