Background Given the role of insulin resistance in several cancers, we hypothesized that the risk of colorectal cancer and colorectal adenoma may be lessened by following a diet that improves insulin resistance. Therefore, we conducted the current study to examine the association between dietary diabetes risk reduction and the odds of colorectal cancer and colorectal adenoma. Method This hospital-based case-control study was conducted on 129 newly diagnosed colorectal cancer patients, 130 newly diagnosed colorectal adenoma cases, and 240 healthy age- and sex-matched hospitalized controls. We used a valid and reliable 148-item food frequency questionnaire (FFQ) to collect the dietary intake of subjects. Multivariate logistic regression was used to estimate the association between DDRRs and the odds of colorectal cancer and adenoma. Results After adjusting for confounding variables, individuals in the highest tertile of the DDRR score were 0.13 and 0.22 times less likely to have colorectal cancer (OR = 0.13, 95% CI: 0.06–0.25) and adenoma (OR = 0.22, 95% CI: 0.12–0.41) respectively Conclusion Current results demonstrated that a high DDRR score was associated with a lower risk of colorectal cancer and adenoma.