Diabetes management requires the control of several metabolic and physiological indicators. Family factors influence metabolic control in persons living with diabetes.To determine the difference in family cohesion and adaptability between patients with controlled type 2 diabetes and those with uncontrolled diabetes.Design: Observational, retrospective, cross-sectional, descriptive, and comparative. Materials and Methods: 147 patients with type 2 diabetes mellitus attending the outpatient clinic of a Family Medicine Unit were included. A survey on metabolic control and the FACES III questionnaire for family cohesion and adaptability were administered.A total of 147 patients were interviewed: 71 uncontrolled patients (48.3%) and 76 controlled patients (51.7%). Among patients with metabolic control, the following family cohesion patterns were found: Unrelated: 72.36%, Semi-related: 15.78%, Related: 6.66%, and Enmeshed: 5.26%. Family adaptability patterns were: Rigid: 1.31%, Structured: 9.21%, Flexible: 3.94%, and Chaotic: 85.54%. Among patients with poor metabolic control, the following family cohesion patterns were found: Unrelated: 85.93%, Semi-related: 7.04%, Related: 1.40%, and Enmeshed: 5.63%. Family adaptability patterns were: Rigid: 12.67%, Structured: 1.40%, Flexible: 9.85%, and Chaotic: 76.08%. For family cohesion, a chi-square value of 5.39 was obtained; p = 0.020. For family adaptability: chi-square value of 0.12; p = 0.726.Families with diabetic patients tend toward extreme cohesion, which is significantly accentuated in those with metabolic dysregulation, who are more frequently classified as unrelated families. Patients with metabolic dysregulation tend to have more rigid family structures compared to the group with metabolic control.Therefore, a lack of cohesion and family rigidity could influence metabolic dysregulation in patients with type 2 diabetes. There is no conflict of interest. The study was submitted for evaluation by the local ethics committee.