Abstract: Objective:To investigate the mediating effect of nutritional literacy on health empowerment and dietary adherence in patients with type 2 diabetes.Methods:A total of 426 patients with type 2 diabetes in inpatient department and outpatient department of Endocrinology Department of the First Affiliated Hospital of Guangxi Medical University from July 2022 to June 2023 were selected as the research objects by convenience sampling method.General data Questionnaire, Chinese version Concise nutritional literacy assessment tool, Chinese version Chronic Disease Empowerment Scale and diet Control Behavior Scale were used to collect data.Structural equation model was used to analyze the mediating effect of nutritional literacy on health empowerment and dietary adherence.Results:Health empowerment was positively correlated with dietary adherence (r=0.493, P< 0.001), health empowerment was positively correlated with nutritional literacy (r=0.589, P< 0.001), and nutritional literacy was positively correlated with dietary adherence (r=0.412, P< 0.001).The total effect of health empowerment on dietary adherence was 0.197(95%CI:0.164-0.230), the direct effect was 0.153(95%CI:0.113-0.194), and the mediating effect of nutritional literacy on health empowerment and dietary adherence was 0.044(95% CI: 0.018-0.070), accounting for 22.33% of the total effect.Conclusion:Nutritional literacy has a mediating effect between health empowerment and dietary adherence in patients with type 2 diabetes.Medical staff can improve nutritional literacy by strengthening the level of health empowerment of patients with type 2 diabetes, so as to promote the dietary adherence.