Background: Hypothyroidism and insulin resistance are significant contributors to metabolic dysfunction and cardiovascular risk. Understanding the interplay between these conditions is crucial for optimising patient care and outcomes. This study aimed to analyse the association between insulin resistance and lipid profiles affecting blood T3, T4, and TSH levels in patients with hypothyroidism. Methods: This study involved the screening and enrolment of 25 patients diagnosed with hypothyroidism and 25 euthyroid patients from the Outpatient Department (OPD) of a tertiary care hospital. This study compared metabolic parameters, including Homeostasis Model Assessment for Insulin Resistance (HOMA-IR) values, thyroid-stimulating hormone (TSH) levels, and insulin levels between hypothyroid and euthyroid individuals. Results: The hypothyroid group exhibited significantly higher HOMA-IR values (mean 3.68 vs. 2.53), TSH levels (mean 10.57 vs. 3.25), and insulin levels (mean 12.65 vs. 9.18) compared to the euthyroid group, indicating greater insulin resistance in hypothyroid individuals. A HOMA-IR cut-off value of 2.65 demonstrated excellent diagnostic accuracy for identifying insulin resistance, with an Area under the Curve (AUC) of 0.795, sensitivity of 68%, and specificity of 76%. Conclusion: The identified HOMA-IR cutoff value serves as a valuable clinical tool for assessing insulin resistance in patients with hypothyroidism and for guiding tailored management strategies.