This study aimed to investigate the association between use of the SGLT2 inhibitors and acute kidney injury (AKI) among diabetic patients. We performed a retrospective cohort study using the Korean National Health Insurance claims data from 2013 to 2022. We selected adult patients newly diagnosed with diabetes between January 2014 and June 2018. Considering the severity of diabetes, we restricted to add-on therapy to metformin and analyzed the risk of AKI associated with prescription of SGLT2 inhibitors compared to sulfonylureas (SU). We used Cox proportional regression models after 1:1 propensity score (PS) matching to determine the hazard ratio (HR) with 95% confidence interval (CI) of SGLT2 inhibitor use on AKI, adjusting for potential confounders. Subgroup analyses were conducted by age, sex, ingredients, and comorbidities.Among the 403,088 patients included in the study, 168,727 patients received SGLT2 inhibitors and 234,361 patients received SU. After 1:1 PS matching, we found that the 133,040  patients balanced the covariates between users of SGLT2 inhibitors and SU. During follow-up, we identified 927 AKI cases (370 among SGLT2 inhibitors users; 557 among SU users). The risk of AKI was significantly lower in SGLT2 inhibitors users compared to SU users (adjusted HR: 0.66, 95% CI: 0.58-0.76). Subgroup analyses revealed AKI risk variations among SGLT2 inhibitors users based on the aforementioned factors.