Several adipokines are produced and secreted from adipose tissue, such as retinol binding protein-4, which triggers metabolic syndromes and insulin resistance. Retinol binding protein-4 transfers vitamin A or retinol in the blood. Higher levels of retinol binding protein-4 are interrelated with progress of metabolic disease, comprising obesity, metabolic syndrome, and type 2 diabetes mellitus. The present study investigates the role of retinol-binding protein-4 levels in type 2 diabetic Iraqi patients with metabolic syndrome. Sixty type 2 diabetic patients aged 40–53 years were examined. Of these 30 patients has metabolic syndrome and 30 without metabolic syndrome. The patients sampled were from the National Diabetes Center/ Mustansiriyah University from February 2022 until the end of August 2022. All diabetic patients have been examined and diagnosed from specialist endocrinology. Also, 30 healthy individuals were selected as control group. Anthropometric and clinical characteristics for all participants were assessed. Serum retinol binding protein-4 concentration was considerably elevated in diabetic patients as paralleled to the control (3.00 ± 0.66 ρg/mL with metabolic syndrome and 2.42 ± 0.88 ρg/ mL without metabolic syndrome). It is observed that female patients with metabolic syndrome had higher concentrations of retinol binding protein-4 (RBP-4) as compared to the male patients. Serum retinol binding protein-4 is strongly correlated with metabolic syndrome. As such concentration of RBP-4 offers enhanced prognostic value over traditional practices, and may be used for early detection of MetS in public health services.