Key PointsQuestionAre oral antiviral medications such as molnupiravir and nirmatrelvir-ritonavir associated with improved outcomes among patients with type 2 diabetes and COVID-19?FindingsIn this cohort study of 22 098 patients in Hong Kong with type 2 diabetes and confirmed SARS-CoV-2 infection, oral antiviral use was associated with a 29% lower risk of all-cause mortality and/or hospitalization for both molnupiravir users and nirmatrelvir-ritonavir users compared with respective control participants.MeaningThese findings suggest that treatment with molnupiravir or nirmatrelvir-ritonavir was associated with a lower risk of all-cause mortality and hospitalization among patients with COVID-19 and type 2 diabetes.