Background <p>This study aimed to investigate the current status of oral frailty in elderly patients with type 2 diabetes mellitus (T2DM) and analyze its influencing factors.</p> Methods <p>We recruited 464 elderly T2DM patients from a tertiary hospital in Taiyuan, Shanxi Province (June-October 2024) using convenience sampling. General information questionnaire, Oral Frailty Index-8 (OFI-8), Fatigue, Resistance, Ambulation, Illness and Loss of weight Scale (FRAIL Scale), Oral Health Assessment Tool (OHAT), and Mini-Nutritional Assessment Short Form (MNA-SF) were used to collect data. Binary logistic regression analysis was performed to identify the factors influencing oral frailty.</p> Results <p>The prevalence of oral frailty was 45.9% among the 464 elderly T2DM patients. Regression analysis identified the following influencing factors (<i>p</i> &lt; 0.05): age, smoking history, weekly frequency of physical activity, duration of diabetes mellitus, polypharmacy, frailty, and oral health score.</p> Conclusions <p>Oral frailty is highly prevalent in elderly T2DM patients. Clinical staff should screen this population for oral frailty early and develop a comprehensive, integrated oral health care program to prevent or delay its onset and progression.</p> Clinical trial number <p>not applicable.</p>