Although the quality of marriage and marriage-like relationships (e.g., cohabitation) has been linked to the risk of developing diabetes and being able to effectively manage the disease once developed, it is unclear which aspects of marital quality drive these associations. Method: Using nationally representative data (Midlife in the United States, N = 800), the present study therefore examines how aspects of marriage (e.g., strain, support, marital risk, and constructive communication) are linked to diabetes outcomes and whether these links vary as a function of sociodemographic characteristics related to health (e.g., gender, race, and income). Results: Strain and marital risk were linked to an increased risk of developing diabetes and strain and poor communication were linked to an increased risk of poor diabetes management. Finally, marital support was linked to a lower risk of diabetes but only for those with lower income. Discussion: These findings inform prevention and intervention programs focusing on social support mechanisms to potentially reduce the risk of developing diabetes (e.g., reduced marital strain and marital instability) and improving diabetes control (e.g., improved communication and reduced marital strain). (PsycINFO Database Record (c) 2018 APA, all rights reserved)