What condition is indicated by sweaty feet odor in urine?

The presence of a sweaty feet odor in urine is indicative of isovaleric acidemia. This metabolic disorder is characterized by a deficiency in the enzyme that is responsible for breaking down isovaleric acid, leading to its accumulation in the body. The odor, often described as similar to that of sweaty feet or socks, results from this accumulation and the body's attempts to excrete excess substances through urine.

In isovaleric acidemia, the characteristic off-putting odor is particularly noticeable after protein intake, as the buildup of isovaleric acid is primarily related to the metabolism of the amino acid leucine. This is a distinct presentation and helps in identifying the condition in clinical settings.

The other options listed do not commonly present with a similar odor in urine. Methionine malabsorption, for instance, can lead to different metabolic consequences but does not specifically produce a sweaty feet smell. Phenylketonuria is associated with a musty odor, while diabetes mellitus may result in sweet-smelling urine due to the presence of excess glucose. Thus, the association of a sweaty feet odor specifically points to isovaleric acidemia as the correct condition indicated by the symptom described.