Background: Contemporary data characterizing the utilization of metabolic and bariatric surgery (MBS) by type 2 diabetes mellitus (T2DM) status are limited. Methods: In this study, we analyzed data from patients 18-88 years of age eligible for MBS seen in the OneFlorida (https://onefloridaconsortium.org/) between 1/1/ 2012 to 12/31/2018. MBS eligibility was defined by any of the following criteria: (1) an encounter with a body mass index (BMI) ≥ 40 kg/m2; or (2) BMI ≥ 35 kg/m2 with at least one obesity-related comorbidity, including T2DM, hypertension, or hyperlipidemia. We compared patients’ characteristics stratified by T2DM status and whether they underwent common bariatric procedures including Roux-en-Y gastric bypass (RYGB), sleeve gastrectomy (SG), and adjustable gastric banding (AGB). We performed multivariable logistic regression to identify factors independently associated with receipt of MBS among diabetic patients. Results: Among 190,606 patients with T2DM, 4103 (2.2%) of them underwent BS. Patients with diabetes were more likely to receive RYGB than those without T2DM (47.6% vs. 37.7%). We also observed that patients without diabetes aged between 18-44 years had a higher rate of MBS utilization than patients in that age range with diabetes (58.7% vs. 37.4%). The logistic regression results showed that female, higher pre-surgical BMI, had pre-surgical hypertension were strong indicators associated with bariatric treatment among patients with diabetes. Conclusion: In this study, we observed that patients with obesity and T2DM still had relatively low rates of MBS. The observed differences in rates of MBS among different demographic subgroups could inform interventions that target reductions in these disparities. Disclosure G. Chen: None. W. T. Donahoo: None. M. Cardel: Consultant; Spouse/Partner; Weight Watchers International, Inc. A. Holgerson: None. A. L. Ayzengart: None. M. J. Gurka: None.