Little is known about the subtypes of type 2 diabetes (T2D) and their association with clinical outcomes in Asians. We performed data-driven cluster analysis in patients with newly diagnosed drug-naive T2D (n = 756) from the Korean Genome and Epidemiology Study. Clusters were based on five variables (age at diagnosis, BMI, HbA1c, and HOMA2 β-cell function, and insulin resistance). We identified four clusters of patients with T2D according to k-means clustering: cluster 1 (22.4 %, severe insulin-resistant diabetes SIRD), cluster 2 (32.7 %, mild age-related diabetes MARD), cluster 3 (32.7 %, mild obesity-related diabetes MOD), and cluster 4 (12.3 %, severe insulin-deficient diabetes SIDD). During 14 years of follow-up, individuals in the SIDD cluster had the highest risk of initiation of glucose-lowering therapy compared to individuals in the other three clusters. Individuals in the MARD and SIDD clusters showed the highest risk of chronic kidney disease and cardiovascular disease, and individuals in the MOD clusters showed the lowest risk after adjusting for other risk factors (P < 0.05). Patients with T2D can be categorized into four subgroups with different glycemic deterioration and risks of diabetes complications. Individualized management might be helpful for better clinical outcomes in Asian patients with different T2D subgroups. Display omitted •Patients with type 2 diabetes can be categorized into four clusters with different diabetes-related outcomes.•Glycemic deterioration needed to initiate anti-diabetic therapy was earlier in severe insulin-deficient diabetes patients.•Patients with mild age-related diabetes and severe insulin-deficient diabetes showed the highest risk of complications.