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Background: Obesity is a predominant factor in development of type 2 diabetes but to which extent adolescent obesity influences adult diabetes is unclear. We investigated the association between body mass index (BMI) in young men and subsequent type 2 diabetes and how, in diagnosed diabetes, adolescent BMI relates to glycemic control and diabetes complications., Methods: Baseline data from the Swedish Conscript Register for men drafted 1968-2005 was combined with data from the National Diabetes and Patient registries. Diabetes risk was estimated through Cox regression and Kaplan-Meier survival estimates. Relationships between BMI, glycemic control and diabetes complications were assessed through multiple linear and logistic regression., Findings: Among 1,647,826 men, 63,957 (3·88%) developed type 2 diabetes over a median follow-up of 29.0 years (IQR[21.0-37.0]). The risk of diabetes within 40 years after conscription was nearly 40% in individuals with adolescent BMI ≥35 kg/m 2 . Compared to BMI 18·5-<20 kg/m 2 (reference), diabetes risk increased in a linear fashion from HR 1·18(95%CI 1·15-1·21) for BMI 20-<22·5 kg/m 2 to HR 15·93(95%CI 14·88-17·05) for BMI ≥35 kg/m 2 , and a difference in age at onset of 11·4 years was seen. Among men who developed diabetes, higher adolescent BMI was associated with higher HbA1c levels and albuminuria rates., Interpretation: Rising adolescent BMI was associated with increased risk of type 2 diabetes diagnosed at a younger age, with poorer metabolic control, and a greater prevalence of albuminuria, all suggestive of worse prognosis., Competing Interests: NS has consulted for Affimune, Amgen, Astrazeneca, Boehringer Ingelheim, Eli-Lilly, Novartis, Novo Nordisk, Pfizer and Sanofi and received grant support from Boehringer Ingelheim. MLind has consulted for Astra Zeneca, Boehringer Ingelheim, DexCom, Eli-Lilly, MSD and Novo Nordisk, and received research grants from Eli-Lilly and Novo Nordisk, all outside the submitted work. Remaining authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© 2022 The Authors.)