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Aims: The incidence of type 2 diabetes in China has exhibited an increasing trend, including younger individuals, over the past years. Early‐onset type 2 diabetes (EOT2D) refers to diabetes diagnosed before 40 years of age. These patients have poor metabolic control and are highly susceptible to diabetic complications, which poses challenges for treatment. However, few studies have reported on the treatment of EOT2D. We determined clinical features and trends in drug use in patients with type 2 diabetes mellitus (T2DM). Materials and Methods: This retrospective study was performed at the Endocrinology Ward, Peking Union Medical College Hospital (PUMCH). "Diabetes" was used when searching PUMCH's Electronic Medical Record Analytical Database to obtain clinical data of patients between January 2013 and May 2022. Results: The analysis included 1590 patients with T2DM. Among them, 609 (38.3%) had EOT2D. Compared with late‐onset type 2 diabetes (LOT2D) patients, EOT2D patients exhibited worse glycemic control and higher body weight and lipid levels despite significant age differences. EOT2D patients also had a higher risk of diabetic retinopathy and nephropathy. Under the general trend of increasing use of dipeptidylpeptidase‐4 inhibitors, sodium‐glucose cotransporter‐2 inhibitors, and glucagon‐like peptide‐1 agonists, patients with EOT2D were more likely to use organ‐protective drugs. Conclusions: Compared with LOT2D patients, EOT2D patients have a longer course of diabetes, worse metabolic control, and a higher rate of developing microvascular complications. The administration of combined therapy, including new agents, may require consideration when selecting hypoglycemic agents for treating EOT2D. [ABSTRACT FROM AUTHOR]