Macronutrient intake is important in the prevention and management of Metabolic Syndrome (MetS). We characterized energy and macronutrient intake of Koreans diagnosed with MetS at recruitment of the Health Examinee (HEXA) cohort. We included 130,423 participants aged 40-69 years for analysis. Odds ratios (OR) and 95% confidence intervals (CI) were estimated to evaluate the intake of macronutrient. Low energy (OR= 0.94, 95% CI: 0.89-0.98) and fat intake (OR=0.91, 95% CI: 0.86-0.97) was observed among 50-59 year-old men. Only postmenopausal women had lower intake of total energy (OR= 0.95, 95% CI: 0.92-0.97) while low fat intake was observed in all women (OR= 0.80 95% CI: 0.77-0.83). For carbohydrate intake, the OR were 1.14 (95% CI: 1.08-1.22) and 1.17 (95% CI: 1.08-1.27) among women in their 50’s and 60’s respectively. Protein intake was low (OR=0.90, 95% CI: 0.86-0.95) and (OR=0.88, 95% CI: 0.82-0.94) among women in their 50’s and 60’s respectively. High intake of plant carbohydrates in women (OR=1.16, 95% CI: 1.12-1.20) and plant protein in both genders (OR=1.09, 95% CI: 1.05-1.13) were observed, but low intake of total energy, fat and animal-source carbohydrates in both genders. Fat intake was low regardless of food source. In conclusion, high consumption of plant-source and low consumption of animal-source macronutrients was observed in Korean adult diagnosed MetS.