Background Acrochordons, otherwise called soft fibromas or skin tags, are small, soft, pedunculated protrusions occurring mainly on the neck and major flexures. They are being investigated as one of the cutaneous markers of diabetes mellitus (DM). The objective of the study was to analyze the clinico-morphological types of acrochordons and to study the association of acrochordons with DM. Materials and methods A descriptive comparative study was conducted in the dermatology outpatient department of a tertiary care hospital in South India over a period of one year. It included 150 cases with acrochordons and a comparative group with age- and sex-matched individuals without acrochordons. All the clinically confirmed cases and comparative groups were subjected to detailed history, clinical examination, and blood and urine tests, and the details were noted in the standard proforma. Statistical analysis was done using Pearson's Chi-squared test. Results Statistical analysis revealed a statistically significant relationship between skin tags and DM (p = 0.0073). Also, there was a significant association between the duration of skin tags and the duration of DM (p= 0.000). The odds ratio was found to be 1.89, which implies that there is a 1.8 times greater risk of an individual with ST developing DM when compared with an individual without a skin tag. Conclusion Skin tags can be considered as an early marker of impaired carbohydrate metabolism and DM.