Objective To investigate the association between microRNA （miR）?23a， miR?150， and miR?150?5p levels and diabetic osteoporosis（DOP） through correlation analysis. Methods A total of 200 patients with diabetes who visited the hospital between March 2020 and March 2022 were selected and followed up for a duration of 2 years. Patients who developed DOP and those who did not were respectively assigned to the DOP group and the non?DOP group. The general information and serum levels of miR?23a， miR?150， and miR?150?5p between these two groups were compared. Pearson correlation analysis was conducted to examine the relationship between serum levels of miR?23a， miR?150， and miR?150?5p， as well as bone density. Logistic regression model was employed to identify factors influencing DOP. Results The incidence rate of DOP was 28.89%. The serum levels of miR?23a， miR?150， and miR?150?5p were significantly elevated in the DOP group compared to the non?DOP group （P < 0.05）. Pearson correlation analysis revealed a negative association between the serum levels of miR?23a， miR?150， and miR?150?5p in diabetic patients and bone density （P < 0.05）. Logistic regression model analysis demonstrated that age， body mass index （BMI）， as well as miR?23a， miR?150， and miR?150?5p were influential factors contributing to the development of DOP （P < 0.05）. Conclusion The levels of serum miR?23a， miR?150， and miR?150?5p are elevated in patients with DOP， and all three exhibit a negative correlation with bone density. Furthermore， these factors collectively contribute to the development of DOP.