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Diabetes mellitus (DM) has been suggested as a potential risk factor for tinnitus, but evidence remains inconclusive. This meta-analysis aimed to evaluate the association between DM and tinnitus by systematically reviewing and synthesizing data from observational studies. A comprehensive literature search was conducted in PubMed, Embase, and Web of Science up to August 16, 2024. Observational studies with a sample size of at least 100 participants that assessed the relationship between DM and tinnitus were included. Studies involving populations with specific diseases were excluded. Odds ratios (ORs) and 95% confidence intervals (CIs) were pooled using a random-effects model. Study quality was assessed using the Newcastle-Ottawa Scale (NOS), and sensitivity and subgroup analyses were performed. Publication bias was evaluated using funnel plots and Egger’s regression test. Twelve studies comprising 2,277,719 participants were included. The pooled analysis revealed a significant association between DM and tinnitus (OR: 1.18, 95% CI: 1.06–1.31, P = 0.002), with moderate heterogeneity (I² = 51%). Sensitivity analyses confirmed the robustness of these findings. Subgroup analyses showed no significant differences by geographical region, mean age, sex distribution, tinnitus diagnosis method, or model used for association estimation. Publication bias was not detected (Egger’s test P = 0.29). These findings suggest that DM is significantly associated with an increased risk of tinnitus. Further research is warranted to explore underlying mechanisms and causal relationships. Nonetheless, the results underscore the importance of monitoring tinnitus in patients with diabetes.