Type 2 Diabetes Mellitus (T2DM) is a growing global health concern, with significant physical, psychological, and social implications. In Pakistan, where health literacy is unevenly distributed and traditional health beliefs remain influential, understanding how individuals self-manage T2DM is essential for designing effective interventions. Objectives: This qualitative study aimed to (1) explore how individuals with Type 2 Diabetes experience and implement lifestyle modifications as part of their disease management in a primary care setting; (2) understand patients’ perspectives on the use of monotherapy medication in managing their Type 2 Diabetes, including perceived effectiveness and challenges; (3) examine how the combination of daily routines, lifestyle changes, and medication use contributes to the self-management of Type 2 Diabetes among patients receiving care in primary healthcare facilities. Methods: Using a qualitative exploratory design, in-depth semi-structured interviews were conducted with 20 participants diagnosed with T2DM, aged 35-55, from Islamabad. Participants were selected through purposive sampling, ensuring variation in gender, education, and socioeconomic backgrounds. Data were analyzed using Thematic Analysis following Braun and Clarke’s (2018) six-step framework. Results: Seven major themes emerged: (1) Recognition and Response to Symptoms, (2) Lifestyle Modifications, (3) Use of Monotherapy (Metformin), (4) Compliance and Self-Management, (5) Impact on Daily Life and Health, (6) Gaps in Support and Resources, and (7) Patient Recommendations and Beliefs. Participants described challenges in symptom interpretation, dietary control, exercise consistency, and medication adherence. Cultural practices, financial limitations, fear of disease progression, and reliance on informal advice shaped their management strategies. Metformin was generally viewed as accessible and effective, though some reported non-compliance due to forgetfulness or lack of awareness. Conclusion: The study emphasizes the need for culturally sensitive, patient-centered care models that integrate lifestyle education, psychological support, and community outreach. Improving awareness, accessibility, and structural support is essential to enhance diabetes outcomes in low-resource settings. Future interventions must be multidimensional, addressing medical, behavioral, and social factors to foster sustainable diabetes management.