PurposeThe purpose of this study was to explore the determinants of diabetes self-management education and support (DSMES) program engagement among Asian Americans with type 2 diabetes living in California.MethodsA qualitative descriptive study was conducted to explore DSMES experiences. Semistructured interviews with Filipino, Korean South Asian, Cambodian, Taiwanese, and Vietnamese Americans were conducted. Participants were recruited through outreach, referrals, and social media. All 12 interviews were audio-recorded and transcribed verbatim. The data analysis used a rigorous, iterative approach, beginning with open coding to generate initial codes, developing a codebook, and proceeding to a second coding level and thematic analysis to interpret key patterns.ResultsAnalysis revealed 4 major themes and 10 subthemes organized using the ecological model. The major themes are (1) individual-level barriers and facilitators (microsystem), (2) cultural and social influences (mesosystem), (3) structural barriers (exosystem), and (4) optimizing DSMES for inclusive diabetes care (macrosystem).ConclusionStudy findings highlight the need for culturally responsive DSMES programs, emphasizing family-centered approaches and prioritization of cultural beliefs. Improving DSMES engagement among Asian Americans requires multilevel interventions addressing systemic and individual barriers, highlighting the complex interplay of cultural, social, and structural factors in diabetes management.