<![CDATA[Dietary adherence remains a significant challenge for individuals with type 2 diabetes mellitus (T2DM), particularly in culturally diverse and food-centered societies like India. Socio-cultural norms, food preferences, family roles, and emotional motivations play a critical role in shaping dietary behavior. This study aimed to explore the lived experiences of Indian adults with T2DM in adhering to dietary recommendations, with a focus on the social, cultural, and behavioral dimensions of diet compliance. A qualitative case study design with a positivist approach was used. Fourteen participants were recruited through snowball sampling from three Primary Health Centers in India. In-depth, semi-structured interviews were conducted, transcribed, and analyzed using thematic analysis. Trustworthiness was ensured through member checking, audit trails, and triangulation. Three major themes emerged: (1) Cultural Negotiation of Food Choices, (2) Internalizing Health Literacy and Self-Regulation, and (3) Family Roles and Emotional Anchors. Participants described the tension between traditional food practices and medical advice, the importance of translating dietary knowledge into practice, and the significant impact of family dynamics and emotional goals on adherence. Dietary adherence among Indian adults with T2DM is a culturally embedded and emotionally driven process. Health professionals must consider cultural traditions, family involvement, and emotional motivations when designing dietary interventions. Family-inclusive and context-specific educational strategies are essential to support sustained adherence]]>
