Introduction: Diabetes mellitus (DM) is a common endocrine disorder globally, characterized by hyperglycemia. Type 2 Diabetes Mellitus (T2DM) progresses insidiously and is associated with microvascular complications, including diabetic retinopathy (DR). Mean Platelet Volume (MPV) serves as a marker for platelet activation and may reflect thrombotic risk in diabetic patients. This study aims to evaluate MPV in T2DM patients and assess its correlation with diabetic complications. Methods: This cross-sectional study was conducted in the Department of Internal Medicine and involved 116 T2DM patients and 116 healthy controls. Baseline investigations, including hemoglobin, leukocyte counts, fasting blood glucose, and MPV, were performed using a fully automated hematology analyzer (Horiba ABX Pentra 80). Statistical analysis was conducted, and a p-value < 0.05 was considered significant. Results: The study included 76 male and 40 female T2DM patients. The mean MPV in diabetic patients was 8.52 fL, significantly higher than the 7.69 fL observed in healthy controls (p < 0.05). Elevated MPV was associated with increased thrombotic potential in T2DM, particularly in patients with microvascular complications. Discussion: Elevated MPV in diabetic patients suggests a potential role for MPV as a marker of thrombotic risk and vascular complications. Larger platelets, which are metabolically active, contribute to this increased risk. MPV showed significant correlation with fasting blood glucose, postprandial glucose, and HbA1c levels. The study aligns with previous research indicating a link between MPV and cardiovascular diseases in T2DM patients. Conclusion: MPV is significantly elevated in T2DM patients, making it a potential marker for assessing thrombotic risk and diabetic complications. The simplicity and cost-effectiveness of MPV measurement make it a valuable tool in clinical practice for monitoring cardiovascular risk in diabetic patients.