<b><i>Background/Objective:</i></b> Insulin resistance (IR) is a metabolic disorder that is increasing worldwide and has been associated with several negative health outcomes. The aim of this study was to evaluate the relationship between different dietary patterns and IR among Mexican children and adolescents. <b><i>Methods:</i></b> We performed a cross-sectional analysis on baseline data from Mexican children and adolescents aged 7–18 years participating in the Health Workers Cohort Study.<b> </b>We included 916 children and adolescents of both sexes. Fasting serum glucose and insulin levels were determined by standardized methods. We defined IR using the homeostasis model assessment (HOMA) as ≥3.5. Factor analysis was used to identify dietary patterns. The associations of interest, those between IR and dietary patterns, were analyzed with multiple logistic regression models. <b><i>Results:</i></b> IR prevalence was 20.3% among girls and boys aged 7–18 years, for whom the prevalence of overweight and obesity was 29.7%. We identified 3 major dietary patterns in this group: ‘Western’, ‘prudent’ and ‘high protein/fat’. For the purposes of this analysis we compared the upper versus the lower quintile of each dietary pattern. Independently of other covariates, participants in the highest quintile of the Western pattern had 92% greater odds of IR (OR 1.92, 95% CI: 1.08–3.43) compared with those in the lowest quintile. <b><i>Conclusions:</i></b> These findings support the hypothesis that high carbohydrate diets like our Western dietary pattern may increase IR in young people. This result emphasizes the importance of preventive nutrition interventions geared toward Mexican children and adolescents.