Purpose This study aimed to identify sex-specific predictors of microalbuminuria in patients with type 2 diabetes mellitus. Recognizing sex-based differences in risk factors may facilitate the early detection and prevention of diabetic kidney disease. Methods: A cross-sectional analysis was performed using data from the Korea National Health and Nutrition Examination Survey. Microalbuminuria was defined as a urinary albumin-to-creatinine ratio ≥30 mg/g. Multivariable complex sample logistic regression analyses were conducted separately for male and female. Independent variables included age, duration of diabetes, glycated hemoglobin (HbA1c), fasting blood sugar (FBS), triglyceride to high-density lipoprotein cholesterol ratio (TG/HDL-C), TG, HDL-C, waist circumference, and systolic blood pressure (SBP). Results: The prevalence of microalbuminuria was higher in male than in female. In both sexes, longer diabetes duration and elevated SBP were associated with microalbuminuria. Among male, FBS, TG/HDL-C ratio, TG, and low HDL-C were significant predictors. In female, HbA1c showed the strongest association, followed by age and diabetes duration. Conclusion: Sex-specific differences were identified in the predictors of microalbuminuria among patients with type 2 diabetes. Incorporating these differences into early screening and individualized care strategies may help improve the prevention of diabetic kidney complications.