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Background: With the global rise in the ageing population and type 2 diabetes mellitus (T2DM), elderly individuals are increasingly prone to complications like sarcopenia and frailty, which are conditions linked to muscle loss and functional decline. These syndromes contribute significantly to morbidity and healthcare burden but remain underestimated in older adults with diabetes. Indian data regarding their prevalence and correlation with glycemic control is limited. Materials and Methods: This hospital-based observational study was conducted over 22 months at Kasturba Medical College, Manipal, involving 160 diabetic patients aged ≥60 years. Clinical features, comorbidities, and diabetes-related complications were recorded. Frailty was assessed using the Edmonton Frailty Scale (EFS), and sarcopenia risk was evaluated using the SARC-F questionnaire. Descriptive statistics and Spearman's correlation were used for analysis. Results: The mean age of participants was 69.98 ± 5.86 years, with 63.1% being male. Fatigue was the most common clinical presentation at 10.6%, while cardiovascular disease was the leading complication at 28.1%. Frailty or pre-frailty was identified in 35% of the population, and 36.9% were at risk for sarcopenia. A strong correlation was found between frailty and sarcopenia risk (p < 0.001). Conclusions: Frailty and sarcopenia are common and closely linked in elderly diabetes, though not significantly associated with glycemic control as both hypoglycemia and hyperglycemia could contribute to frailty.