Aims/Introduction Several epidemiological studies investigated the effect of Helicobacter pylori infection on diabetes, but the conclusions remained inconsistent. We aimed to explore the relationship between H. pylori infection and diabetes, as well as glycemic metabolism profiles. Materials and Methods A cross-sectional study including 58,482 Chinese adults was carried out between January 2016 and December 2017. H. pylori infection was diagnosed by the C-13-urea breath test. Multivariate regression analyses were carried out to evaluate the association of H. pylori infection with diabetes. Results Of the 58,482 participants, 3,449 (5.9%) had diabetes. The H. pylori-positive participants had a higher rate of diabetes (7.3% vs 5.2%, P < 0.001), and higher levels of fasting plasma glucose (5.36 +/- 1.12 mmol/L vs 5.28 +/- 0.95 mmol/L, P < 0.001) and glycated hemoglobin A1c (5.63 +/- 0.68% vs 5.57 +/- 0.60%, P < 0.001) than the H. pylori negative group. Multivariate regression analyses showed that H. pylori infection was positively related to diabetes (odds ratio 1.25, 95% confidence interval 1.15-1.35). Among the H. pylori-positive participants, the elevated levels of fasting plasma glucose and glycated hemoglobin A1c were 0.033 mmol/L (95% confidence interval 0.016-0.049 mmol/L) and 0.024% (95% confidence interval 0.008-0.041%), respectively. Additionally, H. pylori infection was significantly related to diabetes in participants aged >= 44 years, but not in participants aged H. pylori infection is associated with diabetes among Chinese adults. More attention should be paid to adults with H. pylori infection for effective prevention of diabetes.