Introduction <p>Type 2 diabetes mellitus-associated chronic kidney disease (T2DM-associated CKD) is a major cause of kidney failure, cardiovascular complications, and premature mortality. Understanding the global burden, major modifiable risk factors, and future trends of T2DM-associated CKD is essential for healthcare planning and management.</p> Aim <p>This study aimed to characterize the global, regional, and national burden of T2DM-associated CKD from 1990 to 2021, evaluate the distribution of burden attributable to major modifiable risk factors, and project future disease burden through 2040 using data from the Global Burden of Disease (GBD) 2021 study.</p> Method <p>Data were obtained from the GBD 2021 study. The incidence, prevalence, mortality, and disability-adjusted life years (DALYs) for chronic kidney disease due to type 2 diabetes mellitus were analyzed. Decomposition analysis quantified the contributions of population growth, aging, and epidemiological changes. Risk factor analyses identified the leading modifiable contributors to mortality and disability-adjusted life years (DALYs). Future trends through 2040 were projected using an age–period–cohort model implemented with the NORDPRED package.</p> Results <p>From 1990 to 2021, the global burden of T2DM-associated CKD has increased substantially. The male age-standardized incidence rate increased from 19.07 (17.28–20.83) to 23.07 (21.40–24.72) per 100,000 population, and the age-standardized DALY rates also increased. High-SDI regions consistently had the highest incidence, whereas low- and low-middle-SDI regions experienced disproportionately high mortality and disability burdens. East Asia and South Asia contributed the largest number of incident cases, deaths, and DALYs. The disease burden increases markedly with age. Population growth (49.61%) and aging (30.53%) were the principal drivers of the increasing incidence. High fasting plasma glucose and elevated body mass index are the leading modifiable risk factors worldwide. The incidence is projected to continue increasing through 2040, whereas mortality and DALY rates are expected to stabilize or decline.</p> Conclusion <p>T2DM-associated CKD remains a substantial global health challenge, with marked geographic and socioeconomic disparities. These findings support the earlier identification of high-risk individuals, broader implementation of evidence-based renoprotective therapies, and strengthened long-term disease management, and may inform future healthcare planning, resource allocation, and strategies for preventing and managing T2DM-associated CKD.</p>