Diabetes mellitus is a chronic metabolic disease that can cause complications in the form of peripheral neuropathy in older adults, resulting in decreased muscle strength, balance, and functional walking ability. This condition can lead to limitations and a decline in quality of life. Foot ankle exercise, consisting of movements of the feet and ankles, aims to improve blood circulation, strengthen the foot muscles, increase joint flexibility, and prevent complications in the lower extremities, particularly in patients with diabetes mellitus. This study aimed to determine the effect of foot ankle exercise on muscle strength among older adults with diabetes mellitus at Karangmoncol Public Health Center, Purbalingga. A quasi-experimental study with a pretest-posttest control group design involved 68 older adults selected using purposive sampling. The foot ankle exercise intervention was performed in three sessions per week over a period of four weeks. Muscle strength was measured using Manual Muscle Testing (MMT). Data were analyzed descriptively, followed by a normality test. When the data were not normally distributed, the Wilcoxon signed-rank test was used for within-group analysis, while the Mann–Whitney U test was used to compare changes between groups. Hypothesis testing was conducted to assess the effectiveness of the intervention. The intervention group showed an increase in the mean MMT scores of the tibialis anterior (3.47–4.59), gastrocnemius (3.50–4.76), and extensor digitorum longus (3.50–4.62), whereas the control group experienced a decrease in muscle strength. There was a significant difference in the post-test results for all three muscles (p<0.001), indicating that foot ankle exercise was effective in increasing foot muscle strength among older adults with diabetes mellitus. The administration of foot ankle exercise had a significant effect on increasing muscle strength in older adults with diabetes mellitus.