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AIM: To verify the influence of type 2 diabetes mellitus (T2DM) on postextraction socket healing and subsequent first‐stage implant surgery. Materials and Methods: We analyzed pre‐extraction and postextraction cone beam computed tomography images of T2DM patients (n = 75) and paired nondiabetic controls to investigate changes in postextraction socket and ridge dimensions. The types of guided bone regeneration (GBR) surgeries were also compared. Three T2DM pig models were established to compare their postextraction socket healing with that of nondiabetic controls. Healing was quantitatively verified by microcomputed tomography. The osteogenic differentiation of mesenchymal stem cells (MSCs) was also compared. Results: Compared to nondiabetic controls, T2DM patients had higher socket width/depth values postextraction across all groups with different healing times. Among the T2DM patients, 62.7% could not receive first‐stage implant surgery within 6 months postextraction, and 54.7% received GBR surgery during first‐stage surgery. Ossification was not achieved in the socket center of the T2DM pig models after 3 months of healing. A decrease in osteogenic differentiation was observed in T2DM‐MSCs. Conclusions: T2DM interferes with the healing of the extraction socket and thus delays first‐stage implant surgery. This phenomenon may be due to the reduced osteogenic differentiation of MSCs in the sockets. [ABSTRACT FROM AUTHOR]