Background <p>Nutrient patterns impact body composition. Adolescents with obesity and overweight are vulnerable to many metabolic diseases. This study aimed to examine the association between nutrient patterns and muscle mass, fat mass, and BMI in Iranian adolescents.</p> Methods <p>This cross-sectional study was conducted on 451 adolescents from four schools in Jahrom. The frequency and nutritional content of the diet, as well as information about body composition, economic status, and anthropometric measurements, were collected.</p> Results <p>Adolescents were classified into tertiles based on anthropometric indices. Eight major nutritional patterns were identified. High adherence to NP6 (rich in DHA and EPA) was significantly associated with higher odds of being in the second BMI tertile, showing a 190% increase in odds after full adjustment (OR 2.91; 95% CI 1.14–7.42). Moderate adherence to NP5 (rich in fat, MUFA, and sodium) was associated with a 138% increase in odds of being in the second muscle mass tertile in the fully adjusted model (OR 2.38; 95% CI 1.23–4.60). High adherence to NP3 (loaded with cysteine, selenium, magnesium, phosphorus, copper, and vitamin B9) was associated with a 115% increase in odds of being in the second muscle mass tertile after adjusting for confounders (OR 2.15; 95% CI 1.04–4.46). No significant associations were found between any nutritional patterns and fat mass tertiles.</p> Conclusion <p>The current study identified eight distinct NPs. Adherence to NPs containing healthy nutrients was associated with greater odds of muscle mass in adolescents. Conversely, NPs enriched with EPA and DHA were associated with an increased odds of being in the second BMI tertile. Further research, particularly prospective studies, is needed to validate these findings.</p> Graphical Abstract <p></p>