College students with ADHD symptoms and co-occurring difficulties, like functional impairments and mood disorders, have complex symptom profiles marked by unique combinations of comorbid presentations. College students with ADHD often underutilize support services on campus. Subgroups characterized by multiple dimensions may differ in their treatment utilization, and identifying such subgroups is an important first step in enhancing treatment-related selection, implementation, and effectiveness. The purpose of the present study was to identify subgroups of college students with symptoms of ADHD and co-occurring difficulties using latent class analysis (LCA) and understand how service utilization behavior varied among these groups. A sample of 327 adult college students completed an online survey composed of measures to assess ADHD and internalizing symptoms, functional impairment, alcohol use, and service utilization. Based on the LCA, a three-class model was identified as the final solution; the three latent classes that were identified varied both by impairment levels and ADHD symptoms. The results are important in the following ways: ADHD was frequently comorbid with other internalizing disorders; college students reported moderate to high levels of functional impairment particularly in regard to work/school functioning; and students with differing levels of impairment and ADHD symptoms utilized services differently—often those with higher levels of impairment were more likely to utilize services. Discussion of implications, limitations to the study, and future research directions were also included.