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BACKGROUND AND OBJECTIVES To identify the main dietary patterns of adults and investigate the cross-sectional associations of these dietary patterns with prediabetes and undiagnosed or diagnosed diabetes mellitus (DM) in Qingdao, China. METHODS AND STUDY DESIGN This study included 4,457 participants who were administered the semi-quantitative food frequency questionnaire (FFQ). Dietary patterns were identified through principal component analysis (PCA). Logistic regression analysis was performed to determine the associations of each pattern with the risks of prediabetes and undiagnosed or diagnosed DM. RESULTS PCA revealed two major dietary patterns. The Fruits-Vegetables and Poultry-Seafood patterns were not significantly associated with the risk of prediabetes in either crude or adjusted models (all p>0.05). The highest quartile of the Fruits-Vegetables pattern was significantly associated with decreased risks of undiagnosed DM (crude: OR=0.55, 95% CI: 0.41-0.72; Model 1: OR=0.61, 95% CI: 0.46-0.81; Model 2: OR=0.57, 95% CI: 0.42-0.77; Model 3: OR=0.56, 95% CI: 0.41-0.76) and diagnosed DM (crude: OR=0.51, 95% Cl: 0.34-0.75; Model 1: OR=0.59, 95% CI: 0.39-0.88; Model 2: OR=0.60, 95% CI: 0.39-0.93; Model 3: OR=0.59, 95% CI: 0.38-0.91) compared with the lowest quartile in crude and adjusted models. The Poultry-Seafood pattern was not significantly associated with the risk of undiagnosed or diagnosed DM in crude or adjusted models (all p>0.05). CONCLUSIONS The Fruits-Vegetables pattern was associated with a decreased risk of undiagnosed or diagnosed DM.