Background: The purpose of this research work is to explore the patients’ perceptions and experiences of self-management of diabetes in the rural area of Pakistan and to better understand differences in diabetes self-management among men and women living with type 2 diabetes mellitus as well as the barriers and challenges of self-management of diabetes. Methods: 30 participants were recruited from a medical centre at Al-Rehman hospital at Abbottabad, Pakistan. Qualitative method was used to conduct interviews of n = 30 patients with Type 2 diabetes using a semi-structured interview approach with audio recording to explore their perceptions and experiences of the self-management of type 2 diabetes and the factors that influence the management of diabetes. Results: The qualitative analyses revealed six themes: stigma attached to the disease; self-management in context; patient-doctor relationship; adherence to diet and exercise; access to diabetes resources; and social support. Women were more adaptable to diabetic conditions, disclosed their diabetes more readily and are a lot more ready to integrate management into their daily lives, whereas men were more reluctant to tell friends and family about their diabetes due to the stigma attached to the disease and were less observant of self-management practices in social settings. Women used socially interactive resources such as internet access and education classes whereas men relied more on self-directed learning and wanted the guidance of health professionals. Finally, both men and women reported lack of support from the health care practitioners and families in managing their diabetes. Conclusions: The results of this qualitative research highlighted the challenges of diabetes self-management among men and women in the rural area of Pakistan and barriers to self-management. These findings may help to inform gender-sensitive diabetes self-management approach, diabetes awareness in the population, counselling and support.