AbstractIntroductionWe report contemporary age‐related prevalence, characteristics and care of children and young people with type 2 diabetes in England.MethodsIndividuals with a recorded diagnosis of type 2 diabetes between January 2019 and March 2020 were identified from a whole population register. Age, sex, ethnicity, deprivation quintile, weight, HbA_1cand receipt of the nine National Institute for Health & Care Excellence (NICE) recommended annual care processes were extracted from electronic clinical records and analysed by pre‐specified age bands.ResultsIn total, 122,780 (4.6%) of 2,642,435 individuals in England with type 2 diabetes were aged under 40 years, comprising; 650 (0.5%) under 16 years, 910 (0.7%) aged 16–18 years, 8245 (6.7%) aged 19–25 and 112,975 (92%) aged 26–39 years. Compared to people with type 2 diabetes aged above 40 years, young people were significantly more likely to be from minority ethnic groups: 51% under 16 years, 41% 16–18 years, 38% 19–25 years, 38% 26–39 years, 27% 40–59 years and 15% 60–79 years were of Black or Asian ethnicity. In addition, those aged under 40 years were more likely to be obese, women, to live in the most‐deprived socioeconomic areas and less likely to receive the NICE recommended annual care processes or achieve target HbA_1c.InterpretationThe substantial number of people under 40 years of age with type 2 diabetes, are more likely to have characteristics associated with inequalities and are less likely to achieve HbA_1ctargets and receive recommended care processes. These findings highlight the need to consider novel approaches to service provision for this high‐risk group.