Importance: Dyslipidemia, hypertension, and diabetes are highly prevalent conditions for which medical nutrition therapy (MNT) is guideline-recommended, yet access remains limited, and real-world evidence on technology-enabled MNT models at scale is sparse. Objective: To characterize lipid, blood pressure, and glycemic outcomes among adults receiving virtual MNT (vMNT) across three cardiometabolic conditions. Design: Retrospective cohort study of adults with a first Nourish appointment before November 2025, followed for 6 months. Setting: National vMNT platform. Participants: Adults meeting enrollment criteria for dyslipidemia, hypertension, or diabetes and remaining engaged in care with [≥]1 follow-up measurement at 3 or 6 months. Final cohorts: dyslipidemia (n=6,501), hypertension (n=13,704), diabetes (n=2,444); 18,965 unique patients overall. Exposure: vMNT delivered by a registered dietitian via telehealth visits, with technology-enabled support between visits. Main Outcomes and Measures: Outcomes were LDL cholesterol, total cholesterol, HDL cholesterol, and triglycerides (dyslipidemia); systolic and diastolic blood pressure (SBP, DBP) (hypertension); and HbA1c (diabetes), assessed at enrollment, 3, and 6 months. Weight was a secondary outcome. The proportion achieving guideline-recommended targets (HbA1c