Diabetes Mellitus has become a prominent public health issue, which has many different complications including ear, nose, and throat (ENT) conditions. The data regarding the prevalence and patterns of ENT conditions among diabetic patients in Pakistan are limited. The study aimed to explore the frequency and pattern of ENT conditions in patients with diabetes and to assess their associations with demographic and clinical parameters. A descriptive cross-sectional study was conducted at a tertiary care hospital. 230 adult diabetic patients, after which demographic and clinical parameters were collected after patients underwent a thorough examination of the ENT structures. Statistical analysis performed for the associations using chi-square tests and logistic regression. The mean age of the sample was 53.2 ± 12.1 years, with 53.9% being male. 84.3% of the sample had Type 2 diabetes, with mean duration of diabetes of 8.7 ± 6.3 years. The frequency of ENT conditions in diabetic patients was 63.5% (n = 146). The most prevalent ENT conditions included, otitis externa (32.9%), chronic rhinosinusitis (26.7%), sensorineural hearing loss (19.2%), and oral candidiasis ()13.0%. The prevalence of ENT conditions was significantly associated with increasing age (p = 0.031), duration of diabetes (p = 0.018), and poor glycemic control (HbA1c ≥7.0%; p = 0.007). Multivariate analysis showed, age >60 years (OR: 1.78, 95% CI: 1.13–2.81), duration of diabetes of >10 years (OR: 1.92, 95% CI: 1.11–3.33), and poor glycemic control (OR: 2.12, 95% CI: 1.27–3.54) were all independently associated with ENT conditions. The study found the recent evidence that ENT conditions are nearly 63% prevalent among diabetic patients in Karachi, Pakistan, and are more frequent among older patients and patients with longer duration of diabetes and poor glycemic control. Therefore, it is essential that ENT conditions be routinely identified and integrated into the diabetes care model to reduce the morbidity that occurs among diabetic patients.