Background: Glycemic variability has emerged as an important dimension of glycemic control with potential implications for diabetes-related complications and patient-reported outcomes. Objective of this study was to identify the factors associated with glycemic variability and to examine the association between GV and Quality of Life (QOL) among adults with T2DM. Methods: This cross-sectional observational study included 62 adults with T2DM attending a tertiary care centre in South India. Glycemic variability was assessed as the percentage coefficient of variation (%CV) using a single continuous glucose monitoring period. Participants were categorised into three groups based on antidiabetic therapy. QOL was evaluated using the WHOQOL-BREF questionnaire. Associations between GV, clinical variables, and QOL were evaluated using univariable and multivariable linear regression. Results: The median %CV did not differ significantly across treatment groups (Group A: 23.9 [20.9–27.9], Group B: 25.0 [18.4–26.5], Group C: 27.3 [22.4–32.7]; p = 0.39). In multivariable regression, advancing age (β = 0.14, 95% CI 0.02–0.27; p = 0.02) and the presence of microvascular complications (β = 10.82, 95% CI 5.72–15.93; p < 0.01) remained independently associated with higher GV. GV was not independently associated with overall or domain specific QOL (all p > 0.05). However, Group C had significantly lower psychological QOL compared to Group A (59.9 ± 13.9 vs. 76.4 ± 10.8; p < 0.01). Conclusion: Among adults with T2DM, glycemic variability is primarily influenced by age and microvascular complications but is not independently associated with overall or domain-specific quality of life after adjustment for clinical factors.