Aims: To investigate the relationship among NLRP3 inflammasome, glucose and lipid metabolism, and insulin resistance (IR) in the serum of patients with diabetes and pre-diabetes. Methods: A total of 100 patients with abnormal blood glucose divided into the pre-diabetes mellitus (PDM) group (N = 46) and the type 2 diabetes mellitus (T2DM) group (N = 54). 20 normoglycemic subjects (NG, N = 20) were selected as a control group. The serum levels of glucose and lipid metabolism, IR, and the expression of NLRP3, ASC and Caspase-1 were measured. Besides, the correlations of NLRP3 inflammasome with glucose and lipid metabolism, and IR were analyzed. Results: Compared with the NG group, the levels of NLRP3, ASC, Caspase-1, FBG, HbA 1 C, TG, LDL-C, FINs, and HOMA-IR were higher (P < 0.05), while the contents of HDL-C and HOMA-β were lower (P < 0.05) in the serum of both PDM and T2DM groups. Elevated levels of NLRP3, ASC, Caspase-1, FBG, HbA 1 C, FINs, and HOMA-IR were detected (P < 0.05), while decreased contents of HDL-C and HOMA-β were seen (P < 0.05) in T2DM group when compared with those in the PDM group. Correlation analysis found that activation of NLRP3 inflammasome was positively correlated with the concentrations of HbA 1 C, FINs, and HOMA-IR (P < 0.05), but negatively correlated with HDL-C and HOMA-β. Regression analysis further showed that blood glucose related indexes, FINs, and NLRP3 have made a decisive contribution to IR. Conclusions: Collectively, this evidence suggested that NLRP3 is