This study examines the relationship between fat distribution and diabetes in US adults, focusing on sex-specific racial/ethnic groups. Using data from the National Health and Nutrition Examination Survey (NHANES) 2011–2018 (n = 11,972), the researchers analyzed visceral adipose tissue area (VATA) and subcutaneous fat area (SFA) in relation to diabetes prevalence. Key findings include: 1. **Visceral Adipose Tissue (VATA)**: - VATA was positively associated with diabetes in both sexes and across most racial/ethnic groups, except for Black females. - The relationship between VATA and diabetes was stronger in White and Hispanic females compared to Black females. 2. **Subcutaneous Fat Area (SFA)**: - No significant relationship was observed between SFA and diabetes, except for White females (p = 0.032). 3. **Race/Ethnicity**: - The relationship between VATA and diabetes was not affected by race/ethnicity in males. - In females, the relationship between VATA and diabetes was stronger in White, Hispanic, and Asian females compared to Black females. 4. **Conclusion**: - VATA is independently associated with diabetes in both sexes and across most racial/ethnic groups, independent of SFA. - The only significant relationship between SFA and diabetes, independent of VATA, was observed in White females. - The study highlights health disparities in sex-specific racial/ethnic groups and calls for further research to understand these disparities. The study uses a nationally representative sample and direct measures of body composition, providing a comprehensive analysis of the relationship between fat distribution and diabetes.This study examines the relationship between fat distribution and diabetes in US adults, focusing on sex-specific racial/ethnic groups. Using data from the National Health and Nutrition Examination Survey (NHANES) 2011–2018 (n = 11,972), the researchers analyzed visceral adipose tissue area (VATA) and subcutaneous fat area (SFA) in relation to diabetes prevalence. Key findings include: 1. **Visceral Adipose Tissue (VATA)**: - VATA was positively associated with diabetes in both sexes and across most racial/ethnic groups, except for Black females. - The relationship between VATA and diabetes was stronger in White and Hispanic females compared to Black females. 2. **Subcutaneous Fat Area (SFA)**: - No significant relationship was observed between SFA and diabetes, except for White females (p = 0.032). 3. **Race/Ethnicity**: - The relationship between VATA and diabetes was not affected by race/ethnicity in males. - In females, the relationship between VATA and diabetes was stronger in White, Hispanic, and Asian females compared to Black females. 4. **Conclusion**: - VATA is independently associated with diabetes in both sexes and across most racial/ethnic groups, independent of SFA. - The only significant relationship between SFA and diabetes, independent of VATA, was observed in White females. - The study highlights health disparities in sex-specific racial/ethnic groups and calls for further research to understand these disparities. The study uses a nationally representative sample and direct measures of body composition, providing a comprehensive analysis of the relationship between fat distribution and diabetes.