Abstract: Objective: To assess the associations between different metabolic obesity phenotypes and the risks of hypertension, chronic kidney disease (CKD), and hyperuricemia among adults in Southern China. Methods: A total of 8,972 participants were recruited using convenience sampling in this study. According to body mass index (BMI) and metabolic health status, all participants were divided into four groups: the metabolically healthy nonoverweight/obesity (MHNO) group, the metabolically unhealthy non-overweight/obesity (MUNO) group, the metabolically healthy overweight/obesity (MHO) group, and the metabolically unhealthy overweight/obesity (MUO) group. Multivariable logistic regression models were applied to analyze the associations of different metabolic obesity phenotypes with hypertension, CKD, and hyperuricemia. Stratified analyses were further conducted by gender to explore the heterogeneity. Results: Compared with the MHNO group, the risks of hypertension in both the MUNO and MUO groups (MUNO group: OR=2.47, 95% CI: 2.09-2.91; MUO group: OR=3.08, 95% CI: 2.62-3.63) were significantly increased, with the MUO group showing the highest risk. Meanwhile, compared with the MHNO group, both the MUNO and MUO groups had a significantly increased risk of CKD (MUNO group: OR=2.81, 95% CI: 1.95-4.05; MUO group: OR=3.15, 95% CI: 2.20-4.51), as well as a significantly increased risk of elevated urinary albumin-to-creatinine ratio (uACR) (MUNO group: OR=1.90, 95% CI: 1.39-2.61; MUO group: OR=2.37, 95% CI: 1.72-3.26). The risk of hyperuricemia was increased in the MUNO, MHO and MUO groups, with the MUO group exhibiting the highest risk (OR=4.32, 95% CI: 3.47-5.37). Genderstratified analysis revealed that these associations were consistent across both males and females. Conclusion: Metabolically unhealthy status is significantly associated with the risk of multiple cardiometabolic and renal diseases, and this association is further strengthened when combined with obesity.