Type 2 diabetes mellitus (T2DM) is a prevalent metabolic disorder caused by impaired insulin secretion from pancreatic β-cells and insulin resistance in target tissues. Genome-wide association studies have identified over 50 genetic variants linked to T2DM, including polymorphisms associated with the disease. This study investigates the impact of the FADS1 (rs174547) polymorphism in T2DM patients compared to healthy controls and examines serum levels of omega-3 and omega-6 fatty acids, as well as D5D and D6D enzyme levels and activity. This case–control study included 120 participants: 60 newly diagnosed T2DM patients and 60 apparently healthy controls matched for age, sex, and other sociodemographic factors. Polyunsaturated fatty acid (PUFA) levels and desaturase enzyme activities in the n-3 and n-6 pathways were assessed using ELISA and gas chromatography. FADS1 gene polymorphisms were analyzed via Sanger sequencing. Genotype and allele frequencies of FADS1 (rs174547) differed significantly between groups, with higher frequencies of C-containing alleles in T2DM patients. Multivariate analysis revealed a significant association between the C-allele genotype and increased T2DM risk, independent of sociodemographic variables, lipid profile, and inflammatory markers. In conclusion; reduced serum levels of omega-3 and omega-6 fatty acids in T2DM were associated with decreased desaturase enzyme activity. The FADS1 (rs174547) polymorphism is significantly associated with T2DM risk, with the minor allele linked to lower desaturase activity.