Background The number of type 2 diabetes mellitus (T2DM) patients and related treatment costs are rapidly increasing. Consequentially, more cost-effective and efficient strategies for the treatment of T2DM are needed. One such strategy is improving patients’ self-management. As patients are more and more expected to self-manage their disease, it is important to provide them with suitable self-management support. This way, success of self-management will increase and complications and related costs of T2DM can be reduced. Currently, self-management support is developed mainly from the perspective of health professionals and caregivers, rather than patients. This research focused on gaining a better understanding of patients’ perspectives on self-management and support. Methods Semi-structured interviews, preceded by preparatory assignments, were conducted with ten patients with T2DM treated in Dutch primary care. Results We found that patients experience ‘active’ self-management when recently diagnosed. As time progresses and no problems occur, patients do not experience their disease-related behaviour as self-management. Diabetes has ‘just’ become part of their daily life, now including new routines taking diabetes into account. Conclusions With this knowledge, support solutions can be designed and implemented that better fit the needs, preferences and abilities of patients with T2DM. Electronic supplementary material The online version of this article (10.1186/s12913-019-4384-7) contains supplementary material, which is available to authorized users.