This cross-sectional study is aimed to compare health care utilization (HCU) patterns between adults with type 2 diabetes (T2D) alone and those with comorbid heart failure (HF). The sample included 210 adults with T2D (105 without HF and 105 with HF) from a tertiary healthcare setting in Addis Ababa, Ethiopia. The diabetes health care utilization (DHCU) tool was adapted to measure self-reported HCU. The Mann-Whitney U was used to compare the differences in HCU. The frequency of HCU ranged from 0 to 7 visits to the provider, 0 to 3 emergency room visits, 0 to 6 foot examinations and 0 to 11 nights in hospital in the last 6 months, and 0 to 96 months since the previous eye examination. T2D adults with comorbid HF had significantly higher emergency room visits and total days in hospital. In this group, persons living alone had significantly higher provider visits, emergency room visits, and total days in hospital but lower months since the previous eye examination. Men had a higher frequency of foot examination than women. Findings show that HF increases HCU and is higher among those who live alone. Integrated self-care interventions for HF comorbid adults with T2D and who live alone are suggested to help reduce unplanned HCU.