OBJECTIVE: To investigate the association of frailty status with all-cause and cardiovascular disease (CVD) mortality in individuals with diabetes. METHODS: Data was sourced from the Third National Health and Nutrition Examination Survey (NHANES III, 1988-1994), NHANES (1999-2006), and the UK Biobank. Frailty status was assessed using the Fried phenotype and classified as non-frailty, pre-frailty, and frailty. We further performed a meta-analysis involving 19 prospective cohort studies (753,480 patients) to summarize the existing evidence. RESULTS: We included 31,225 diabetes patients from NHANES III (mean age 63.3 ± 0.8, 56.4 % female), NHANES 1999-2006 (mean age 61.6 ± 0.4, 49.7 % female), and the UK Biobank (mean age 59.6 ± 7.2, 39.5 % female). The prevalence of frailty was 9.9 %, 10.7 %, and 12.1 % across respective cohorts. During a follow-up period exceeding 13 years, we observed consistent results that frailty and pre-frailty were significantly associated with increased risks of all-cause and CVD mortality in diabetes. Notably, of the five domains used to assess frailty phenotypes, low gait speed showed the strongest association with all-cause and CVD mortality risks. Meta-analysis showed that, compared to non-frailty, frailty in patients with diabetes was associated with a 1.8-fold higher risk of all-cause mortality and a 2.0-fold higher risk of CVD mortality. Similarly, pre-frailty was associated with a 1.3-fold higher risk of all-cause mortality and a 1.4-fold higher risk of CVD mortality. CONCLUSIONS: This study established a strong association between frailty, pre-frailty, and increased all-cause and CVD-related mortality in diabetes. Integrating frailty assessment into routine practice to identify frail and pre-frail status early on is recommended, followed by the implementation of targeted healthy lifestyle interventions to mitigate adverse outcomes.