Background Previous studies have demonstrated the relationship between adipocyte factors, insulin resistance, and other indicators with telomere length. However, these studies did not consider the influence of changes in different indicators on telomere length over time. Therefore, the aim of this study is to elucidate the impact of changes in adipocyte factors, HOMA-IR, and other indicators on the dynamic variation of telomere length.Methods The data were from a cohort study conducted in Ningxia, China. A total of 1624 subjects were analyzed. Adipokines and relative leukocyte telomere length (RLTL) were measured, and changes in Homeostatic Model Assessment for Insulin Resistance (HOMA-IR), Homeostatic Model Assessment for beta-Cell Function (HOMA-beta), and Quantitative Insulin Sensitivity Check Index (QUICKI) were calculated. Generalized linear models evaluated associations between changes in adipokines and RLTL changes. Furthermore, univariate analyses examined the effects of changes in adipokines and insulin resistance indicators on Delta RLTL.Results The research findings indicate that females generally have shorter telomeres compared to males. In comparison to the low-level group of Delta leptin (LEP), the high-level group of Delta LEP shows a negative correlation with Delta RLTL (B=-1.32, 95% CI (-2.38, -0.27)). Even after multivariable adjustments, this relationship persists (B=-1.31, 95% CI (-2.24, -0.23)). Further analysis reveals that after adjusting for Delta HOMA-IR, Delta HOMA-beta, and Delta QUICKI, the high-level group of Delta LEP still exhibits a significant negative correlation with Delta RLTL (B=-1.37, 95% CI (-2.43, -0.31)). However, the interaction effects between Delta HOMA-IR, Delta HOMA-beta, Delta QUICKI, and Delta LEP do not affect Delta RLTL.Conclusions Elevated levels of leptin were significantly correlated with shortened telomere length. This suggests that increased leptin levels may impact overall individual health by affecting telomere length, underscoring the importance of measures to reduce leptin levels to mitigate the onset and progression of related diseases.