Vitiligo is a cutaneous autoimmune disorder characterized by progressive depigmentation due to melanocyte destruction by cytotoxic T cells. Genetic factors predispose patients to the disease, supported by environmental factors often initiating new disease episodes. We questioned whether disease outcomes are partially defined by pathogenic microbes driving nutrient deficiencies and inflammation. Our study presents results from research on the diet and gut microbiome composition of vitiligo patients and healthy controls from Kazakhstan and the USA. Dietary nutrient intake was assessed using NIH-generated Diet History Questionnaires. Vitiligo patients with active disease exhibited limited intake of specific fatty acids, amino acids, and zinc. Disease activity was further characterized by an abundance of Odoribacter and Escherichia genera in the gut. Metabolic pathway analysis supported a role for the Escherichia genus in disease activity by limiting energy metabolism and amino acid biosynthetic pathways. Disease activity also aligned with elevated circulating pro-inflammatory cytokines. These findings suggest that nutritional limitations are not compensated by metabolites from the gut microbiome in active disease, potentially leaving room for inflammation and exacerbating vitiligo. The intricate relationship between diet, gut microbiome composition, and disease progression in vitiligo highlights potential avenues for targeted interventions to reduce autoimmune activity and improve patient outcomes.