Patients with lung cancer may experience heterogeneous combinations of physical, functional, practical, and interpersonal problems that are not adequately captured by conventional average-based analyses. This exploratory cross-sectional study aimed to identify latent classes of supportive care problem burden and examine their associations with emotional problems and patient characteristics. From March to June 2026, 142 inpatients with lung cancer were recruited from Shanxi Bethune Hospital. Nine binary supportive care indicators were included in latent class analysis, and one- to five-class models were fitted. Emotional problem count, derived by summing nine binary emotional items, was compared across classes using the Bolck–Croon–Hagenaars method, while exploratory univariable R3STEP analyses examined associations between patient characteristics and class membership. A two-class solution was retained (entropy = 0.831). Class 1, the fatigue-dominant symptom–functional high-burden class, included 16 patients (11.3%) and was characterized by prominent fatigue, gastrointestinal and eating problems, pain, physical activity limitation, and household and caregiving difficulties. Class 2, the relatively lower symptom–functional burden class, included 126 patients (88.7%). Class 1 had a higher emotional-related problem count than Class 2 (2.791 vs. 1.765; χ² = 5.632, p = 0.018). Higher Eastern Cooperative Oncology Group performance status was associated with greater odds of Class 1 membership (odds ratio = 2.84, 95% confidence interval: 1.41–5.75, p = 0.004). These exploratory findings suggest heterogeneity in reported supportive care problems, with external validation required before the class structure can guide clinical stratification.