Heatwaves have long been recognized as a serious public health threat. Effective adaptation measures can reduce the risks to people and ecosystems. The purpose of this study was to explore the determinants of heatwave adaptive behaviors using the Health Belief Model (HBM) as a framework. A cross-sectional study was conducted among a sample of 686 participants who were registered volunteers at the Alkhidmat Foundation in Pakistan, using an online questionnaire. For individual adaptive behaviors, only perceived benefits and self-efficacy were observed as significant predictors. For household adaptive behaviors, only cues to action and self-efficacy were found as significant predictors. In terms of overall adaptive behaviors, perceived benefits, perceived barriers, cues to action, and self-efficacy were significant predictors. Our study explores the influence of the HBM constructs on adaptive behaviors across various subgroups, highlighting their differential significance in rural and urban settings, formal and informal occupations, and experiences within heatwaves. These findings highlight the potential of the HBM in guiding the creation of impactful interventions that facilitate behavioral changes during heatwaves, thereby enhancing people’s adaptive behaviors. By emphasizing the association of the HBM with adaptive behaviors, our findings offer valuable insights for authorities seeking to make informed decisions and policies.