Proper classification of diabetes is a significant challenge in contemporary healthcare, especially related to early detection and clinical decision support systems. This study aims to optimize the Extreme Learning Machine (ELM) model with a metaheuristic approach to improve performance in diabetes classification. The data used was an open dataset containing the patient's medical attributes, such as age, gender, smoking status, body mass index, blood glucose level, and HbA1c. The initial process includes data cleansing, one-hot coding for categorical features, MinMax normalization, and unbalanced data handling with SMOTE. The ELM model was tested with four activation functions (Sigmoid, ReLU, Tanh, and RBF) each combined with three metaheuristic optimization strategies, namely Particle Swarm Optimization (PSO), Genetic Algorithm (GA), and Bat Algorithm. The results of the evaluation showed that the combination of the Tanh activation function with GA optimization obtained the highest accuracy of 87.98% and an F1-score of 0.5489. Overall, GA optimization appears to be superior to all other measurement configurations in consistent classification performance. The main contribution of this study is to offer a systematic approach to select the best combination of activation functions and optimization algorithms in ELM, as well as to provide empirical evidence to support the application of metaheuristic strategies to improve the accuracy of disease classification based on health data. This research has direct implications for the development of a more precise and data-based medical diagnostic classification system for diabetes.