Objective <p>This study examined the effect of central obesity measures and pancreatic fat on beta-cell function in individuals with newly diagnosed type 2 diabetes mellitus.</p> Methods <p>In this cross-sectional study, we recruited 108 patients with newly diagnosed type 2 diabetes mellitus and 33 socio-demographically matched non-diabetic controls. At the time of recruitment, central obesity indices were determined using waist and hip circumference, and pancreatic fat ratio was quantified through non-contrast computed tomography.</p> Results <p>Patients (53.8% male, mean age 53.5 years) had a mean body mass index of 27 and a mean visceral fat tissue ratio of 5.09. Compared to controls, the patients showed significantly higher waist circumference, body shape index, body roundness index, visceral fat tissue ratio, and pancreatic fat ratio. Notably, the Homeostatic Model Assessment of Beta-cell function was significantly higher in the patients with central obesity (defined by waist circumference, <i>p</i> = 0.01). We observed a weak to moderate positive correlation between pancreatic fat ratio, C-peptide levels, and the beta-cell function model. A positive correlation also existed between pancreatic fat ratio and waist circumference (<i>r</i> = 0.353, <i>p</i> &lt; 0.001).</p> Conclusion <p>Our cross-sectional findings suggest an association between impaired insulin regulatory mechanisms, crucial for the distribution of visceral and subcutaneous fat in central obesity, and newly diagnosed type 2 diabetes mellitus. This highlights the interplay observed between central and pancreatic fat deposition and beta-cell dysfunction at a single point in time.</p>