Background: This case report demonstrates the acute onset of diplopia due to isolated abducens nerve palsy secondary to uncontrolled diabetes, presenting as ophthalmoplegia. Case description: A 55-year-old female with a history of type 2 diabetes mellitus (DM) and hypertension presented with sudden onset binocular horizontal diplopia in the past 15 days, which was greater at a distance and worsened on looking toward the right. Ophthalmological examination was unremarkable except for right eye abduction limitation on lateral gaze. Blood investigations revealed glycated hemoglobin (HbA1c)—11.8, fasting blood sugar (FBS)—271, postprandial blood sugar (PPBS)–385, and the rest of the reports were unremarkable. Fundoscopic examination of eyes was normal. Magnetic resonance imaging (MRI) brain and orbit were also normal. A diagnosis of isolated sixth nerve palsy (ISNP) secondary to uncontrolled diabetes was made. Subsequently, the patient was put on oral hypoglycemia agents, insulin, aspirin, and dark goggles with alternate eye occlusion therapy. Over the course of 4 days of hospital stay, the patient noticed a 20% improvement in her symptoms. Conclusion: It is important to consider sixth nerve palsy in poorly controlled diabetic patients presenting with diplopia with normal neurological findings.