Objective: to detect factors related to negative adherence to self-care in individuals with diabetes mellitus. Methods: observational, cross-sectional, analytical, and exploratory study, conducted with individuals diagnosed with type 2 diabetes mellitus and followed-up by the Family Health Strategy. The sample consisted of 250 participants. The Summary of Diabetes Self-Care Activities Questionnaire was used for self-care assessment. Association tests, prevalence ratio and Poisson regression with robust variance were performed in the analysis. Results: negative attitudes related to self-care increased by 21% for single/divorced/widowed, 20% for retired, 54% for those who did not diet, 28% for those who did not practice physical activity, 24% for hypertensive, 30% for those with dyslipidemia, and 44% for those with retinopathy. Conclusion: socioeconomic factors, behavioral factors, presence of comorbidities and complications related to diabetes mellitus were related to negative adherence to self-care.