Background: Diabetes mellitus is a chronic metabolic disorder frequently associated with a wide range of cutaneous manifestations. Skin lesions in diabetic patients may reflect underlying metabolic control and systemic complications. Aim: To study the clinical patterns of dermatoses in diabetic patients and establish clinicopathological correlation. Materials and Methods: A hospital-based cross-sectional study was conducted on 90 diabetic patients attending the Dermatology Department at Mata Gujri Memorial Medical College and LSK Hospital, Kishanganj, Bihar, from January to December 2024. Detailed clinical evaluation and relevant laboratory investigations were performed. Skin biopsies were taken in 40 selected cases and examined histopathologically. Data were analysed using SPSS version 21. Results: The majority of patients (32.2%) were aged 51–60 years, with a male predominance (60%). Type 2 diabetes accounted for 86.7% of cases. Poor glycemic control (HbA1c ≥ 9%) was found in 42.2% of patients. Infectious dermatoses (35.6%) were most common, followed by diabetic dermopathy (20%) and pruritus/xerosis (11.1%). Among infections, fungal infections were predominant (56.3%). A clinicopathological concordance of 92.5% was observed. Conclusion: Cutaneous manifestations are frequent in diabetes and correlate with disease duration and glycemic control. Histopathological evaluation is valuable for confirming the diagnosis and understanding the underlying pathology. Regular dermatological assessment should be included in the comprehensive management of diabetic patients.