Objective To analyze the clinical characteristics of type 2 diabetes mellitus (T2DM) complicated with osteoporosis (OP), and conduct logistic regression analysis to screen the influencing factors. Methods A total of 380 patients with T2DM admitted to the Second Affiliated Hospital of Xi'an Jiaotong University from January 2022 to December 2024 were selected. The patients were divided into the OP group (84 cases) and the non-OP group (296 cases) based on bone mineral density. Clinical data and biochemical indicators were compared between the two groups, and logistic regression analysis was used to identify the influencing factors of T2DM complicated with OP. Results The proportions of females and patients with smoking history were higher in the OP group than those in the non-OP group (P<0.05). Glycated hemoglobin (HbA1c) level in the OP group was higher than that in the non-OP group, and 25-hydroxyvitamin D3 (25(OH)D3) level was lower than that in the non-OP group (P<0.05). Multivariate logistic regression analysis showed that female gender, smoking, high HbA1c level, and low 25 (OH) D3 level were risk factors for T2DM complicated with OP. Conclusion Type 2 diabetes patients with osteoporosis have the clinical characteristics of a high proportion of women and a high proportion of smoking history, and they exhibit higher HbA1c levels and lower 25(OH)D3 levels. Female gender, smoking, high HbA1c level, and low 25(OH)D3 level are risk factors for OP in patients with T2DM.