Enhanced adipose tissue IRF5 expression in diabetic obese patients parallels with the signatures of metabolic inflammation. The data presented in this study support a model of metabolic inflammation in type-2 diabetes, in which, increased adipose IRF5 gene expression in diabetic obese patients concurs with the local expression of a wide variety of inflammatory markers including TNF-α, IL-18, IL-23A, CXCL8, CCL2/7, CCR1/5, CD11c, CD68, CD86, TLR4/7/10, Dectin-1, FGL-2, MyD88, NF-κB, IRF3, and AML1. On the other hand, in diabetic lean/overweight patients, adipose IRF5 gene expression was found to correlate with BMI, body fat percentage, insulin levels, HOMA-IR index, plasma CRP, and adipose IL-5 and IL-1RL1 transcripts expression. In all diabetic patients, regardless of the status of their obesity, adipose IRF5 transcripts correlated with IRF4, TLR2/8, and CD163 gene expression. Altogether, these changes imply that the adipose tissue IRF5 upregulation may represent a novel marker of metabolic inflammation in type-2 diabetes.