Established risk factors for multiple myeloma, including obesity and sedentary lifestyles, are associated with well-known racial/ethnic disparities in disease risk. This review examines established risk determinants for multiple myeloma in Black adults, summarizes evidence linking lifestyle factors, including obesity, physical inactivity, and diet, to disease risk, and discusses energy balance interventions, including cultural tailoring, to mitigate multiple myeloma risk. We summarize current evidence for racial/ethnic disparities in risk factors for multiple myeloma, including unmodifiable heritable factors, modifiable contributors to obesity, including diet and physical activity, and barriers to meeting physical activity and healthful diet guidelines. With this evidence, we present considerations to research lifestyle interventions directed toward risk factors for multiple myeloma. Current foundational scientific evidence in energy balance interventions for cancer risk management is primarily supported in non-Hispanic White populations. Evidence for preventative exercise, diet, or lifestyle interventions for multiple myeloma among underrepresented populations is scarce. Research considerations are proposed to provide strategies utilizing community engagement, primary care education, and importantly, availability of exercise and dietary resources. The importance of tailoring exercise and dietary interventions is also underscored, in addition to generating clinical trial-based evidence to be equitable and beneficial for all populations.