ALB and diabetes mellitus: SHAP analysis revealed that the most significant predictors were PIR, antihypertensive medication use, hemoglobin, red blood cell count, albumin, and diabetes.<h4>Conclusion</h4>The machine learning model developed in this study can effectively predict the risk of frailty in middle-aged and older adults with CKM Stages 0-3, providing a valuable tool for early identification of high-risk individuals in clinical practice.