Objective In recent years, social media platforms, such as TikTok and RedBook, have emerged as important channels through which users access and share medical information. Additionally, an increasing number of healthcare professionals have created social media accounts through which to disseminate medical knowledge. This paper explores why users obtain their medical information from social media and how the signals transmitted by social platforms affect use behaviours. Methods We combined the elaboration likelihood model and signal theories to construct a comprehensive model for this study. We used simple random sampling to investigate users’ behaviours related to social media usage. A total of 351 valid questionnaires were completed by people in Mainland China. The participants were enthusiastic about social media platforms and had searched for health-related information on social media in the past three months. We analysed the data using partial least squares structural equation modelling to investigate the influence of two pathways and two signals (objective and subjective judgement pathways and positive and negative signals) on social media use behaviours. Results When seeking medical information on social media, users tend to rely on subjective judgment rather than objective judgment, although both are influential. Furthermore, in the current era, in which marketing methods involving big data algorithms and artificial intelligence prevail, negative signals, such as information overload, have a more pronounced impact than positive signals. Conclusions This study demonstrates that the subjective judgment path has a greater impact on users than the objective judgment path. Platforms are encouraged to focus more on users’ emotional needs. The paper also discusses the negative impact of information overload on users, sounding an alarm for enterprises to control their use of homogeneous information resulting from the excessive use of big data algorithms.