Purpose: The purpose of this study was to examine the association between objectively measured physical activity and hearing sensitivity among a nationally representative sample of U.S. adults with diabetes. Method: Data from the 2003-2006 National Health and Nutrition Examination Survey were used. One hundred eighty-four U.S. adults with diabetes wore an ActiGraph 7164 accelerometer and had their hearing function objectively assessed. A negative binomial logistic regression was used to examine the association between moderate-to-vigorous physical activity (MVPA) and hearing sensitivity. Results were adjusted for age, gender, race/ethnicity, education, body mass index, comorbidity index, marital status, cotinine, homocysteine, high-density lipoprotein cholesterol, glycohemoglobin (HbA[subscript 1c]), C-reactive protein, microalbuminuria, noise exposure, and vision impairment. Results: Compared to those with "hearing within normal limits," results showed that participants with "mild hearing loss" and "moderate or greater hearing loss," respectively, engaged in 93% fewer minutes of MVPA (incident rate ratio = 0.07; 95% CI [0.01, 0.60]) and 94% fewer minutes of MVPA (incident rate ratio = 0.06; 95% CI [0.01, 0.54]). Conclusion: Adults with diabetes who have greater hearing impairment are less physically active. Future research is needed to determine the direction of causality.