A review of a regional diabetes service in Auckland has highlighted an increasing incidence of T2D in children and adolescents, particularly in high-risk ethnic groups. Patients at the service aged <15 years were analysed between January 1995 and December 2023 (n = 226). The incidence of T2D increased 8.3% per year over the full observation period. For the period 2020 to 2023, the overall incidence rate was 5.81 per 100 000 persons. Incidence rates according to ethnic group were 10.3, 9.84 and 0.45 per 100 000 persons for Pacific peoples, Māori, and New Zealand Europeans, respectively.