Objective <p>To evaluate the association between diabetes mellitus (DM) and meibomian gland dysfunction (MGD) through a comprehensive meta-analysis, identifying potential implications.</p> Methods <p>A systematic search of PubMed, Embase, Web of Science, and Google Scholar was conducted to identify observational studies published in English from January 2000 to March 2023. Studies reporting odds ratios (ORs) with 95% confidence intervals (CIs) or sufficient data to calculate these metrics, using clear diagnostic criteria for DM and MGD, were included. Meta-analysis was performed using a random-effects model, and heterogeneity was assessed with the I² statistic. Subgroup analyses were conducted based on study design, region, and diagnostic methods.</p> Results <p>Thirteen studies, including 13,629 participants, were analyzed. The pooled OR for the association between DM and MGD was 1.66 (95% CI: 1.27–2.18), indicating a statistically significant increased risk of MGD in diabetic individuals. Significant heterogeneity (I² = 83%) and potential publication bias were observed, likely reflecting variability in study design, population characteristics, and diagnostic methods. Subgroup analysis revealed a stronger association in case–control studies and Asian populations. Studies using infrared meibography reported a higher pooled OR with lower heterogeneity.</p> Conclusion <p>This meta-analysis demonstrates a significant association between DM and MGD, suggesting that DM increases the risk of MGD. These findings emphasize the importance of early screening and management of MGD in diabetic patients to improve ocular health outcomes and dry eye symptoms. Future research should focus on addressing diagnostic inconsistencies and exploring causative mechanisms to strengthen the evidence base.</p>