Objective: To investigate the influencing factors associated with subclinical carotid atherosclerosis (SCAS) in patients with newly diagnosed type 2 diabetes mellitus (T2DM) and regression after comprehensive treatment. Methods: Data were collected from 402 patients with newly diagnosed T2DM, grouped according to the presence or absence of SCAS, and the differences in the indicators between the two groups were compared. Using binary logistic regression to analyze factors influencing newly diagnosed T2DM combined with SCAS. Risk factor cut-off values were analyzed using reciever operating characteristic (ROC) curves. Seventy-two of these patients were followed up to compare the metabolic index attainment and SCAS detection rate before and after the comprehensive treatment. Result: The SCAS detection rate among 402 newly diagnosed T2DM hospitalized patients was 57.0% (229/402). The differences in diabetic peripheral neuropathy (DPN), diabetic retinopathy (DR), estimated glomerular filtration rate (eGFR), triglycerides (TG), body mass index (BMI), and heart rate were statistically significant (P < 0.05) when the SCAS group was compared with the non-SCAS group. Binary logistic regression analysis showed that the independent influences of newly diagnosed T2DM combined with SCAS included DPN, DR, eGFR, and BMI (P < 0.05). ROC curve analysis showed an eGFR cutoff value of 103.50 mL/min/1.73 m2 and a BMI cutoff value of 27.32 kg/m2. Compared with baseline, patients' carotid intima-media thickness (CIMT), SCAS detection rate and metabolic indexes were significantly improved after 1 year of intervention, and the difference between the two groups was statistically significant (P < 0.05). Conclusion: High rate of SCAS detection in hospitalized patients with newly diagnosed T2DM. DPN and DR are positively associated with the risk of newly diagnosed T2DM combined with SCAS. Elevated BMI and decreased eGFR are independent risk factors for newly diagnosed T2DM combined with SCAS. Combination therapy improves metabolic indexes, relieves CIMT thickening, and reduces SCAS detection rate in patients with newly diagnosed T2DM, but carotid plaque is not significantly improved.