Purpose: To address the prevalence of diabetes distress (DD) and its correlators in adults with type 2 diabetes.<br />Patients and Methods: During 2021 and 2022, we conducted a cross-sectional study in three Class A tertiary comprehensive hospitals in China, and received 947 participants who completed a printed survey covering DD, demographic, diabetic, physiological, and psychosocial factors. We used Jonckheere-Terpstra, chi-square, and Fisher's exact tests to assess intergroup differences between different levels of DD. We used ordinal logistic regression analysis to analyze correlators of DD further.<br />Results: The prevalence of DD was 34.64%. In univariate analysis, those with lower satisfaction with financial status, longer durations of diabetes, more complications, higher glycemia, more severe insomnia, treatment by medications only, poorer lifestyle interventions, fewer self-care activities, more types and frequencies of insulin injections, and spending more money and time on treatment were susceptible to DD. Type D personality, negative illness perceptions, negative coping styles, and psychological effects of major life events were related to higher DD. Hope, self-efficacy, positive coping styles, and social support can reduce DD. In ordinal logistic regression analysis, hypoglycemic episode (beta=- 1.118, p=0.019, "have hypoglycemic" as reference) and Brief Illness Perception Questionnaire (beta=0.090, p< 0.001) were significant positive correlators for DD, while diet intervention (beta=0.803, p=0.022, "have diet intervention" as reference), money spent on diabetes treatment (beta<-0.001, p=0.035), and SES (beta=- 0.257, p< 0.001) were significant negative correlators.<br />Conclusion: More than one-third of Chinese adults with type 2 diabetes experience moderate or high levels of DD. DD was associated with financial, diabetic, physiological, and psychosocial status.