diff --git a/news/4292.bugfix b/news/4292.bugfix
new file mode 100644
index 00000000..d3e01008
--- /dev/null
+++ b/news/4292.bugfix
@@ -0,0 +1,3 @@
+Fix ``plone.api.user.create()`` to respect ``use_uuid_as_userid`` and
+``use_email_as_login`` registry settings, as well as custom ``IUserIdGenerator``
+and ``ILoginNameGenerator`` utilities.
diff --git a/setup.py b/setup.py
index 2d2d1dd4..7355b7b0 100644
--- a/setup.py
+++ b/setup.py
@@ -27,6 +27,7 @@
         "Products.PlonePAS",
         "Products.CMFPlone",
         "decorator",
+        "plone.app.users",
         "plone.app.uuid",
         "plone.app.dexterity",
         "plone.app.intid",
diff --git a/src/plone/api/tests/test_user.py b/src/plone/api/tests/test_user.py
index a7140bdb..4f8283fb 100644
--- a/src/plone/api/tests/test_user.py
+++ b/src/plone/api/tests/test_user.py
@@ -113,6 +113,9 @@ def test_create_with_username(self):
         )
         self.assertEqual(user.getUserName(), "chuck@norris.org")
 
+        # Delete user before recreating with different login settings,
+        # because generate_user_id uses username as user_id in both cases.
+        api.user.delete(user=user)
         self._set_emaillogin(False)
 
         user = api.user.create(
diff --git a/src/plone/api/user.py b/src/plone/api/user.py
index 96a47083..2e93b98f 100644
--- a/src/plone/api/user.py
+++ b/src/plone/api/user.py
@@ -65,16 +65,29 @@ def create(
             "that is not email so you need to pass a username.",
         )
 
+    # Generate user_id and login_name using the canonical implementation
+    # from plone.app.users, respecting use_uuid_as_userid,
+    # use_email_as_login, IUserIdGenerator, and ILoginNameGenerator.
+    from plone.app.users.utils import generate_login_name
+    from plone.app.users.utils import generate_user_id
+
+    site = portal.get()
+    data = {
+        "username": username,
+        "email": email,
+        "fullname": properties.get("fullname", ""),
+    }
+    user_id = generate_user_id(site, data) or username or email
+    login_name = generate_login_name(site, data) or username or email
+
     registration = portal.get_tool("portal_registration")
-    user_id = use_email_as_username and email or username
 
     # Generate a random 8-char password
     if not password:
         chars = string.ascii_letters + string.digits
         password = "".join(random.choice(chars) for char in range(8))
 
-    properties.update(username=user_id)
-    properties.update(email=email)
+    properties.update(username=user_id, email=email)
 
     registration.addMember(
         user_id,
@@ -82,7 +95,14 @@ def create(
         roles,
         properties=properties,
     )
-    return get(username=user_id)
+
+    # If user_id differs from login_name (e.g. UUID as user id with
+    # email as login), update the login name accordingly.
+    if user_id != login_name:
+        pas = portal.get_tool("acl_users")
+        pas.updateLoginName(user_id, login_name)
+
+    return get(userid=user_id)
 
 
 @mutually_exclusive_parameters("userid", "username")