ProposeThe present study has sought to investigate the prevalence of diabetes and its related risk factors, to examine the relationship between demographic variables, anthropometric indices, sleep quality, and Metabolic Equivalent Task (MET) with diabetes in Khuzestan province, southwest Iran.MethodsThe present study has a cross-sectional design (the baseline data of the Hoveyzeh cohort study as a sub-branch of the Persian Prospective Cohort Study). Comprehensive information from 10,009 adults (aged 35–70 years) was collected from May 2016 to August 2018 through a multi-part general questionnaire containing general characteristics, marital status, education, smoking, sleep quality, MET, and anthropometric indices. Data analysis was performed by SPSS software version 19.ResultsThe mean age of the sample was 52.97 ± 8.99 years. 60.3% of the population were women and 67.7% were illiterate. Out of the 10,009 people surveyed, 1,733 stated that they have diabetes (17%). In 1,711 patients (17%) the amount of FBS was ≥126 mg/dl. There is a statistically significant relationship between diabetes and MET. More than 40% had BMI above 30. Anthropometric indices in diabetic and non-diabetic individuals were different. Also, there was a statistically significant difference between the mean duration of sleep and the use of sleeping pills in diabetic and non-diabetic groups (p < 0.05). Based on logistic regression, marital status [OR = 1.69 (95% CI, 1.24, 2.30)], education level [OR = 1.49 (95% CI, 1.22, 1.83)], MET [OR = 2.30 (95% CI, 2.01, 2.63)], height [OR = 0.99 (95% CI, 0.98, 0.99)], weight [OR = 1.007 (95% CI, 1.006, 1.012)], wrist circumference [OR = 1.10 (95% CI, 1.06, 1.14)], waist circumference [OR = 1.03 (95% CI, 1.02, 1.03)], waist-to-hip ratio [OR = 3.41 (95% CI, 2.70, 4.29)], and BMI [OR = 2.55 (95% CI, 1.53, 4.25)], are good predictors for diabetes.ConclusionThe results of this study showed that the prevalence of diabetes in Hoveyzeh city, Khuzestan, Iran, was almost high. and emphasize that preventive interventions should focus on risk factors, especially socioeconomic status, and anthropometric indicators along with lifestyle.