Objective: To analyze the characteristics of potential profiles of psychological distress in adolescents and young adults (AYAs) with thyroid cancer and to explore the population characteristics and factors. Methods: 213 AYAs with thyroid cancer were assessed using the general information questionnaire, Strategies Used by People to Promote Health (SUPPH), and the specific Cancer Distress Scales for Adolescents and Young Adults (CDS-AYA) from February to July 2023. Results: Three potential profiles of psychological distress were finally identified: “lower” (67.1%), “general” (25.8%), and “higher” (7.1%) psychological distress groups. Logistic regression analysis showed that the presence of underlying disease, treatment modality, tumor-node-metastasis (TNM), and self-management efficacy were the factors in the potential psychological distress profiles among AYAs with thyroid cancer. Conclusion: This study identified heterogeneity in psychological distress among AYAs with thyroid cancer and classified it into three profiles. Factors influencing the potential characteristics of psychological distress in thyroid cancer patients include underlying disease, treatment modality, TNM, and self-management efficacy. Nurses should be attentive to the psychological well-being of AYAs with thyroid cancer. Nurses could adopt different interventions according to the individual characteristics of patients, to reduce psychological distress and improve mental health.