ABSTRACT Introduction Diabetes mellitus is a global noncommunicable disease epidemic of public concern. Adherence poses a challenge to patients due to the long-term management of type 2 diabetes. This study assessed the factors associated with antidiabetic medications and dietary recommendation adherence among patients with type 2 diabetes in Ghana. Methods A hospital-based, cross-sectional study design was used to assess self-reported factors associated with antidiabetic medications and dietary recommendation adherence among 165 recruited type 2 diabetes patients who visited diabetic clinics of two selected municipal hospitals in the Volta region of Ghana. A structured questionnaire consisting of closed-ended questions was used. Phone calls were used to collect responses from participants using the structured questionnaire, which included the United Kingdom Diabetes Diet Questionnaire and Morisky Adherence Scale. Data collected were entered into a Microsoft Excel sheet and exported to STATA software (version 15) to analyze variables. Binary logistic regression was run to determine the association between the level of adherence (outcome variable) and the independent variables. A CI of 95% with a p-value of < 0.05 was statistically significant. Results Self-reported factors were as follows: forgetfulness (p = 0.0001), taking medication (p = 0.006), difficulty remembering to take medication (p = 0.001), worry about long-term intake of drugs (p = 0.0001), choice of high-fiber diet (p = 0.037), intake of processed or refined carbohydrate (p = 0.049) alcohol intake (p = 0.033), age (p = 0.015), occupation (p = 0.009), and patient waiting time (p = 0.020) were found to have contributed to medication/dietary nonadherence among the participants. Conclusion Patient adherence was low. Health authorities in the two selected hospitals should develop strategies to reduce the problem of poor adherence.