Background Previous studies indicate that serum folate is inversely associated with metabolic syndrome (MetS). This study aims to investigate the association between serum folate, homocysteine (Hcy) levels, and cardiometabolic risk in patients with type 2 diabetes (T2D). Methods Associations between serum folate, Hcy levels, and cardiometabolic risk factors were assessed in a cross-sectional study of 755 participants with T2D. Results In individuals with MetS, the serum folate levels were significantly lower than in subjects without MetS, whereas the serum Hcy was significantly higher. Serum folate level was negatively correlated with CRP, body mass index (BMI), serum Hcy, triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), serum uric acid (UA), and diastolic blood pressure (DBP) but positively correlated with high-density lipoprotein cholesterol (HDL-C). Furthermore, serum Hcy concentrations were positively correlated with BMI, UA, total cholesterol, TG, and LDL-C. A multiple linear regression analysis was used to identify predictors for cardiometabolic risk. Low serum folate levels were identified as an independent risk factor for obesity and dyslipidemia in patients with T2D. Moreover, high serum Hcy levels were positively associated with serum UA and hypertension after adjusting for potential confounders. Conclusion Low serum folate levels was an independent risk factor for obesity and dyslipidemia in the T2D population. High Hcy levels were positively associated with serum UA and hypertension.