Aim <p>This study aimed to investigate sex-specific associations and the synergistic effects of aging and glycemic control on the correlation of possible sarcopenia in older adults with type 2 diabetes mellitus (T2DM).</p> Methods <p>In the cross-sectional study of community-dwelling adults aged ≥ 60 years in New Taipei City, Taiwan, Sarcopenia status was classified using the Asian Working Group for Sarcopenia 2019 criteria into possible sarcopenia, sarcopenia, and severe sarcopenia. Categorical and continuous variables were compared using chi-square/Fisher’s exact tests and ANOVA. Sex-specific associations between glycemic control and sarcopenia were examined using logistic regression to estimate odds ratios (ORs) and 95% confidence intervals (CIs).</p> Results <p>5,728 participants (mean age 72.1 ± 6.1 years; 47.9% men) were enrolled. After adjustment, older women with T2DM had a higher odds of possible sarcopenia (OR = 2.07, 95% CI = 1.57–2.72). In women aged ≥ 70 years, both good and poor glycemic control were significantly correlated with possible sarcopenia (OR = 1.87 and 2.10; 95% CI = 1.16–3.04 and 1.43–3.07; p for trend &lt; 0.0001). T2DM patients with hypertension, ischemic heart disease (IHD), or depression showed increased sarcopenia association (OR = 1.71, 1.81, and 2.45, respectively). Poor glycemic control revealed increased odds of sarcopenia in those with hypertension (OR = 1.80) or IHD (OR = 2.42).</p> Conclusions <p>Glycemic control could be crucial in preventing possible sarcopenia, especially among older women with T2DM. Comorbid hypertension, IHD, or depression are significantly associated with sarcopenia in T2DM patients, particularly in the presence of poor glycemic control.</p>