Background: Type 2 diabetes mellitus (T2DM) is among the leading chronic diseases causing hospitalizations and costs to the public institutions worldwide. Additionally, micro- and macrovascular complications of T2DM increase mortality. Objective: To identify the presence of chronic complications (micro- and macrovascular), associated with overweight and obesity, in adult patients with T2DM. Methods: The data used in this retrospective cohort study were obtained from the Non-Communicable Diseases Analysis System(SANENT)® of the Instituto Mexicano del Seguro Social (IMSS). To identify the factors related to cardiovascular complications and mortality, a multiple logistic regression model was performed. Results: This study included 3,807,621 T2DM patients with an average age of 61.1 years and a female predominance of 58.8%. A total of 46.5% of the patients presented obesity, 30% were overweight, 16.8% had systemic hypertension (SH), and 1.05% had dyslipidemia. A total of 32.6% had uncontrolled blood sugar, and 29.44% had some type of comorbidity. Age and number of comorbidities were consistent risk factors for the presence of these alterations, followed by SH, which was a risk factor for cerebrovascular disease, chronic kidney disease, retinopathy and amputation. Regarding hospital death, uncontrolled blood glucose, SH, age and comorbidities were risk factors. It should be noted that the factor with the greatest impact was the presence of comorbidities. Conclusions: The risk factors that had the greatest impact on chronic complications were the number of comorbidities and age, followed by SH. For hospital death, the risk factors were uncontrolled blood glucose, SH, age, and the number of comorbidities.