• Smoking is classified as a modifiable risk factor that increases the risk of developing type 2 diabetes mellitus (T2DM). • Pathophysiological mechanisms by which components of tobacco smoke cause glucose intolerance and worsen clinical outcomes in patients with T2DM include: increased insulin resistance, impaired β-cell function and insulin secretion, chronic low-grade inflammation, endothelial dysfunction, indirect interaction with other factors that worsen diabetes.Control of risk factors in people with diabetes mellitus: blood pressure, glycemia, lipid profile, smoking, physical activity, body weight control, dietary habits.• Epidemiological studies on the association between cigarette smoking and the development of type 2 diabetes have shown, in a study of 50,000 Chinese individuals followed for 5.4 years, that participants who smoked ≥20 cigarettes per day had an increased hazard ratio for developing T2D of 1.25 (95% CI: 1.00–1.56), while men with a smoking history of ≥40 cigarettes had an increased risk of T2D of 1.28 (95% CI: 1.04–1.57).• In the European Prospective Investigation into Cancer (EPIC-Norfolk) study of 2,704 men and 3,385 women, smoking was shown to be associated with an increase in HbA1c. Smokers of both sexes showed similar changes in HbA1c values—[an increase of 0.12% per 20 pack-years].• Healthy diet, regular physical activity, smoking cessation, and regular blood glucose monitoring are the main recommendations for diabetes control. • If you are not a smoker, do not start smoking; if you are, the best choice is to quit.• Is there an alternative for those who choose an unhealthy lifestyle despite negative health consequences?