Diabetes is a metabolic disease that leads to a high risk of fracture related to osteoporosis. Noninvasive and reliable assessment of osteoporosis is essential for clinical practice. The aim of this study was to explore the agreement of the Proton Density Fat Fraction (PDFF) values of lumbar vertebra measured by Magnetic Resonance Imaging (MRI) IDEAL-IQ sequences at different field strengths and to investigate the value of IDEAL-IQ in the assessment of osteoporosis risk in diabetic.