Abstract: Objective To analyze the comorbidity patterns of chronic metabolic diseases and their influencing factors among people aged 35-75 years old in Nantong City of Jiangsu Province, and to provide theoretical support for the prevention and control of comorbidities. Methods The permanent residents aged 35-75 years from the Comprehensive Prevention and Control Project of Cardiovascular and Cerebrovascular Diseases in Nantong City from 2021 to 2024 were selected as the research subjects. Clustering analysis and association rule were used to investigate the comorbidity patterns of chronic metabolic diseases, and their influencing factors were identified through logistic regression analyses. Results The prevalence of comorbidity of chronic metabolic diseases among residents aged 35-75 years in Nantong City was 47.40%. Among comorbidity patterns based on disease counts, the prevalence of hypertension+dyslipidemia was highest in binary patterns (6.25%), while that of hypertension+dyslipidemia+obesity was highest in ternary patterns (4.01%). Association rules showed that in both binary and ternary comorbidity patterns, the confidence was highest for obesity+hypertension (72.70%) and obesity+dyslipidemia+hypertension (74.54%), .Renal insufficiency formed an independent cluster in cluster analyses. Logistic regression analyses revealed that, compared with the non-comorbidity group, males (OR=2.22, 95% CI: 1.69–2.91), advanced age (45–54 years, OR=1.38, 95% CI: 1.02–1.88; 55–64 years, OR=1.59, 95% CI: 1.14–2.23; 65–75 years, OR=2.34, 95% CI: 1.58–3.47), and low physical activity (OR=1.26, 95% CI: 1.10–1.65) were influencing factors for metabolic disease comorbidity.. Conclusion In the comorbidity patterns of chronic metabolic diseases among individuals aged 35-75 years in Nantong City, hypertension, diabetes mellitus, and dyslipidemia interact with each other. Individuals with obesity are more prone to diseases such as hypertension and dyslipidemia. Prevention and control of chronic metabolic diseases should be strengthened for males, individuals with low physical activity and advanced age.