SHAP ranked 15 predictors, with age showing the highest importance, followed by diabetes duration, fasting glucose, body mass index, diastolic blood pressure, height, smoking history, Cystatin C, systolic blood pressure, hemoglobin A1c, weight, estimated glomerular filtration rate, total cholesterol, insulin use, and sex.<h4>Conclusion</h4>A random forest model using routinely available clinical data identified RDR without fundus imaging. Here, INS is linked to diabetes mellitus.