Understanding the key factors in managing type 2 diabetes over the long term has become necessary. This study aims to explore the association between illness perception, coping, and self-care adherence among adults with type 2 diabetes and find the influence of illness perception and coping on self-care adherence. A cross-sectional survey design was used to collect data from 123 adults with type 2 diabetes aged between 30 and 55 years. The questionnaires included the Brief Illness Perception Questionnaire (BIPQ), Brief COPE, Self-Care Inventory-Revised (SCI-R), and a personal information sheet. A significant correlation was found between illness perception, maladaptive and adaptive coping strategies, and self-care adherence. Adaptive coping, illness perception, and maladaptive coping strategies together explained a 59.9% variance in self-care adherence (F(3, 119) = 59.29, p < .001). The study highlights the importance of developing a less threatening perception of the illness and enhancing the practice of adaptive coping strategies for achieving better self-care adherence among people with type 2 diabetes. This study signifies the need for a collaborative approach by healthcare professionals, mental health providers, and policymakers to provide accurate diabetes self-management knowledge and develop interventions tailored to individuals’ needs.