Background: This study aims to investigate the genetic contribution of polymorphic variants of the TCF7L2 (rs7903146) and PPARG (rs1801282) genes to the risk of developing prediabetes in individuals of Kazakh ethnicity. Materials and Methods: This was a case-control study involving 200 cases with prediabetes and 200 prediabetes-free controls, aged 16–60 years (n = 400). Real-time polymerase chain reaction on a StepOnePlus instrument (Applied Biosystems, USA), employing the TaqMan method for site-specific amplification and genotyping of the TCF7L2 (rs7903146) and PPARG (rs1801282) genes was used. Results: Patients with prediabetes had a higher birth weight, increased BMI, larger waist and hip circumferences, and a higher waist-to-hip ratio compared to healthy patients in the control group. There was a significant increase in the risk of developing prediabetes for both the rs1801282 polymorphism of the PPARG gene and the rs7903146 polymorphism of the TCF7L2 gene. The risk was 9.8 times higher in carriers of the GG genotype of PPARG (rs1801282) (OR = 9.769, 95% CI: 2.124–44.922, p = 0.003) and 10.7 times higher for carriers of the TT genotype of TCF7L2 (rs7903146) (OR = 10.731, 95% CI: 1.309–87.939, p < 0.001). Conclusions: These findings highlight the need for tailored early screening and preventive strategies for prediabetes in the Kazakh population, focusing on individuals with high-risk genotypes. Such efforts could improve targeted interventions and reduce the burden of prediabetes. Future research should adopt a longitudinal design, include diverse ethnic groups, and investigate additional genetic markers to provide a more comprehensive understanding of the genetic underpinnings of prediabetes.