Objective: The aims of this study were to assess health-related quality of life (HRQOL) among adult patients with diabetes attending primary health care diabetes clinics in Kuwait and to examine the factors associated with the HRQOL of patients with diabetes. Methods: This cross-sectional study was conducted among 503 patients with diabetes attending 26 primary health care diabetes clinics in Kuwait. A self- administered questionnaire on participants’ socio-demographic and clinical characteristics, in addition to the Diabetes Self-Management Questionnaire (DSMQ) to assess patients’ diabetes self-management (DSM), was used. The SF-12 was employed to assess the HRQOL, producing the following 2 outcomes: physical health composite (PHC) and mental health composite (MHC). Results: The mean age of participants was 52 ± 0.8 years, and 53.1% were males and 49.0% were Kuwaitis. The median DSM sum score was 6.5. Male patients with diabetes showed a significantly better median DSM sum score than female patients with diabetes. The overall median score of HRQOL was 61.7/100, with a better median PHC versus MHC score of quality of life (66.7/100 and 56.7/100, respectively). Multivariate analysis revealed a significant direct association between DSM and better primary health composite and MHC scores. It also showed that female gender and reporting 2 or more diabetic complications were significantly associated with a poor PHC. Conclusions: Kuwaiti patients with diabetes showed a modest level of HRQOL. Patients’ DSM, gender, and diabetes complications were significant independent correlates to HRQOL. Appraisal of the HRQOL of patients with diabetes as an essential component of diabetes management in clinical settings is suggested. Further studies to examine the impact of good DSM on HRQOL improvement are needed.