Introduction: We assessed whether the coronavirus disease 2019 (COVID-19) pandemic was associated with within-individual delays in diabetes care processes of glycated hemoglobin (HbA1c) testing, retinal exam, and nephropathy evaluation among patients receiving regular care with Wake Forest Baptist Health (WFBH), overall and stratified by clinical factors, race and ethnicity, and socioeconomic status. Methods: We used electronic health record data for 25,323 WFBH adult patients with diabetes (96% type 2; 53% women; mean age ± SD: 63±13 years). We used Current Procedural Terminology codes to identify each diabetes care process occurring between 3/1/2018 and 2/28/2021. Delayed care between serial assessments was defined as a duration of >6 months for HbA1c testing and >12 months for retinal exam and nephropathy evaluation. We used individual-level fixed effects regression to estimate within-person change in outcomes before and after the start of the COVID-19 pandemic (3/1/2020), overall and among subgroups. Results: During the pandemic, there was a 12.7 to 20.6 percentage point increase in the incidence of delayed diabetes care ( Table ). We did not observe clinically meaningful differences in delayed care for any of the diabetes care procedures during the pandemic across socio-demographic subgroups. However, individuals with the highest HbA1c and greatest burden of comorbidities, respectively, had the greatest increase in the incidence of a delayed HbA1c test during the pandemic. Conclusions: The COVID-19 pandemic was associated with an increase in within-individual delays in HbA1c testing, retinal exams, and nephropathy evaluations. Delays were greatest for individuals with the most severe disease and may portend an increase in diabetes complications.