The review presents data on skin changes (acanthosis nigricans, xeroderma, scleredema, diabetic rubeosis, diabetic dermopathy, necrobiosis lipoidica, etc.) occurring in diabetes mellitus and other components of the metabolic syndrome. Some common potential mechanisms of development of metabolic syndrome and skin diseases such as psoriasis, acne vulgaris, hidradenitis suppurativa, androgenetic alopecia, acanthosis nigricans and atopic dermatitis are discussed. Skin manifestations may be signs of insulin resistance and impairment glucose tolerance, xanthomas and xanthelasmas are sings of dyslipidemia. Psoriasis and hidradenitis suppurativa are often associated with metabolic syndrome and obesity. Acne, hirsutism and androgenetic alopecia are widely signs of hyperandrogenism. A better understanding of correlation between metabolic syndrome and skin diseases contributes to early diagnosis and prevention, as well as provides the key to develop new therapeutic strategies. Primary care physicians, as well as dermatovenerologists and cosmetologists can play a key role in early detection and therefore earlier treatment of metabolic syndrome, contributing to the reduction of the associated with this pathological syndrome cardiovascular risk.