This　study　aimed　to　develop　and　validate　a　predictive　model　of　all-cause　mortality　risk　in　American　adults　aged　＞=　18　years　with　diabetes.　7918　participants　with　diabetes　were　enrolled　from　the　National　Health　and　Nutrition　Examination　Survey　(NHANES)　1999-2016　and　followed　for　a　median　of　96　months.　The　primary　study　endpoint　was　the　all-cause　mortality.　Predictors　of　all-cause　mortality　included　age,　Monocytes,　Erythrocyte,　creatinine,　Nutrition　Risk　Index　(NRI),　neutrophils/lymphocytes　(NLR),　smoking　habits,　alcohol　consumption,　cardiovascular　disease　(CVD),　urinary　albumin　excretion　rate　(UAE),　and　insulin　use.　The　c-index　was　0.790　(95%　CI　0.779-0.801,　P　＜　0.001)　and　0.792　(95%　CI:　0.776-0.808,　P　＜　0.001)　for　the　training　and　validation　sets,　respectively.　The　area　under　the　ROC　curve　was　0.815,　0.814,　0.827　and　0.812,　0.818　and　0.829　for　the　training　and　validation　sets　at　3,　5,　and　10　years　of　follow-up,　respectively.　Both　calibration　plots　and　DCA　curves　performed　well.　The　model　provides　accurate　predictions　of　the　risk　of　death　for　American　persons　with　diabetes　and　its　scores　can　effectively　determine　the　risk　of　death　in　outpatients,　providing　guidance　for　clinical　decision-making　and　predicting　prognosis　for　patients.