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Objective To explore the current dietary patterns of different obesity metabolic phenotypes in the middle-aged and elderly population in Sichuan area. Methods From the baseline survey of the Natural Population Health Cohort Study at West China Hospital, Sichuan University from 2019-2021, 15 160 eligible middle-aged and older adults were screened out, and then based on their obesity metabolic phenotypes, they were divided into metabolic healthy non-obesity (MHNO), metabolic unhealthy non-obesity (MUNO), metabolic healthy obesity (MHO) and metabolic unhealthy obesity (MUO) groups. Dietary survey was conducted by food frequency questionnaire. The dietary pattern was extracted by principal component analysis. ANOVA was performed to compare the differences in energy and nutrients among the participants with different dietary patterns. Chi-square test was used to compare the distribution of dietary patterns among people with different obese metabolic phenotypes, and stratified analysis was performed by gender and age groups. Results Among the 15 160 middle-aged and elderly participants in Sichuan area, there were 8 340 (55.0%) in the MHNO group, 4 789 (31.6%) in the MUNO group, 763 (5.0%) in the MHO group, and 1 268 (8.4%) in the MUO group. The dietary patterns of these participants mainly consisted of following 4 types: legumes and fruits (22.5%), rice, flour and pickled products (25.5%), offal and drinks (21.1%) and egg and milk (30.9%). The dietary patterns of the different obesity metabolic phenotypes were distributed as follows: the MHNO, MUNO and MHO groups had a predominantly egg and milk diet, while the MUO group had a predominantly rice, flour and pickled products diet. There were statistical differences in the distributions of dietary patterns among different obesity metabolic phenotypes (P < 0.05): the dietary patterns of rice, flour and pickled products accounted for the following percentages among different obesity metabolic phenotypes: MUO>MUNO>MHNO; the dietary patterns of egg and milk were lower in the MUO group than in the MHNO and MUNO groups. The distribution of dietary patterns for the metabolic phenotypes of obesity was statistically different in all age groups of women(P < 0.05). For the women aged 45- < 60 years, the distribution of dietary patterns of obesity metabolic phenotypes was similar to that found in the total population. For the women aged ≥60 years, the offal and drinks dietary pattern was more common in the MUO group than the MHNO and MUNO groups. Conclusion There are differences in the distribution of dietary patterns among middle-aged and elderly people with different obesity metabolic phenotypes in Sichuan area. It is recommended that the MUO people should reduce the intake of rice, flour and pickled products and increase the intake of eggs and milk in their daily diet. In addition, for the female MUO people ≥60 years of age, the intake of offal and beverages should be reduced appropriately.