Abstract: The comorbidity of type 2 diabetes mellitus(T2DM) with thyroid nodules(TN) is discussed, and the theoretical implications of the compound pathogenesis of phlegm, constraint, stasis and heat are explored. The study introduces the pathogenesis evolution of T2DM and TN in Chinese medicine, and discusses the evolutional characteristics of the compound pathogenesis of T2DM combined with TN. The pathological factors center around phlegm and stasis, which are compounded with constraint, dampness, dryness, heat, etc. The corresponding location of the disease is mainly in the liver and kidney, and is also closely related to the heart, spleen, and lung. The nature of the disease is based on yin deficiency. From the modern biological point of view, the evolution of the compound pathogenesis of T2DM combined with TN is presented as follows. Firstly, insulin resistance is related to the production of phlegm, dampness, and stasis. Secondly, glucolipid metabolism is related to the formation and transformation of phlegm, dampness, and stasis. Thirdly, the formation of chronic inflammation is related to the pathological state of deficiency-excess complex. Thus, the combination of reductionist biomedicine and the holistic view of Chinese medicine is expected to provide new ideas for the modernization of the homotherapy for heteropathy in Chinese medicine.