Abstract Background China has the highest number of diabetics globally, necessitating refined disease management strategies. Diabetes Internet-based nursing clinic services (INCS) can significantly improve health behaviors, blood glucose levels, and help prevent complications. The services mainly rely on the Internet platform for nurses’ door-to-door service abroad, while China’s “Internet + Nursing Service” combines online and offline modes. Nonetheless, patient receptivity to the services is still ambiguous. This study aims to explore diabetics’ experiences of INCS, identify key factors affecting their participation, and suggest strategies to enhance service quality. Methods From May to December 2022, 14 diabetics who had used INCS were selected through purposive sampling and maximum differentiation sampling from a hospital in Hefei, China. A semi-structured interview was conducted based on the Health Information Technology Acceptance Model (HITAM) to develop the interview outline. Interviews were transcribed verbatim within 48 h and analyzed using Nvivo 12.0 software. Directed content analysis examined factors affecting diabetic patients’ use of the services, while traditional content analysis explored patient experiences and suggestions. Results The four themes of diabetic patients’ experiences of INCS were content and effectiveness of Internet-based nursing clinic services, nurses’ service attitude and level, timeliness of services, and service platform design. Factors influencing service adoption behavior include five themes: health status, perceived usefulness, perceived ease of use, subjective norm, and social influences, and three sub-themes, namely Internet development trends, epidemic of COVID-19, and the difficulty of accessing medical care offline. Patients’ suggestions for the service included two themes: enriching the service channels, improving the platform’s function, and fixing the consultation time to improve service efficiency. Clinical trial number Not applicable. Conclusions Eleven (78.6%) of the people with diabetes generally had a positive experience with INCS, recognizing its assistance, though they were also worried about the effects of diagnosis and treatment. Medical institutions should promote INCS and highlight the role of medical staff to improve patients’ awareness of the service’s benefits. They should encourage patient utilization of service by improving the platform’s functionality and enhancing age-friendly design.