Introduction: The high prevalence of obesity in adults with type 2 diabetes (T2D) has become a major public health burden. This study explored the readiness to change for weight loss in adults with T2D with obesity, examining its association with sociodemographics, health status, dietary self-efficacy, and social support for physical activity and diet. Materials and methods: This cross-sectional study involved 381 adults with T2D with obesity in Kemaman, Terengganu. The stages of change were dichotomized into ‘not ready’ and ‘ready'. The self-efficacy was measured using the Weight Efficacy Lifestyle Questionnaire (WEL-Q), and the social support for physical activity was measured using the Social Support Scale for Diet and Physical Activity Questionnaire. Results: More than half of the participants (50.4%) were still not ready to change for weight loss. Multiple logistic regression showed patients who are not married (p = 0.011), obtained tertiary education (p = 0.018), have a higher score in self-efficacy for social pressure (p < 0.001) and received better family support for physical activity (p = 0.001) tend to be ready for weight loss efforts. Conclusion: This study identified marital status, academic background, self-efficacy for social pressure, and family support for physical activity as the determinants in influencing the readiness to change for weight loss in adults with T2D with obesity. The results highlight the importance of targeting the large proportion of adults with T2D who are not ready to lose weight, providing valuable insights to improve obesity interventions within this population.