Background: Obesity is among the most common causes of male infertility. Infertility rates have risen in recent years among men, particularly those with concomitant health issues besides obesity, such as varicocele or diabetes, in couples who underwent in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI). Objective The goal of this study was to see how varicocele and diabetes affected semen quality, hormonal profile, the rate of fertilization, the quality of the embryo, and the pregnancy rate after intracytoplasmic sperm injection (ICSI) in overweight men. Patients and methods: The study involved 150 couples who were recruited from the assisted reproductive unit at Al-Azhar University. International Islamic Center for Population Studies and Research. Control (C), overweight with varicocele (OW & V), and overweight with diabetes (OW & D) were the three groups (each with 50 participants). For each case, the biochemical, antioxidants, and sperm parameters were examined. Then, during and after the ICSI procedure, fertilization, cleavage, embryo quality, and pregnancy rates were all checked and recorded. The percentages of fertilization rate and high-quality embryos in the OW & V and OW & D groups were significantly less than in the control group (p<0.001). However, it was noted that abnormal sperm morphology increased and the percentage of positive pregnancy tests was reduced by 50% in OW and V, followed by OW and D (55%). Conclusion: The overweight males with varicocele and the overweight with diabetes males had considerably worse semen parameters and hormone profiles, as well as decreased rates of fertilization, pregnancy, and embryo quality.