The prevalence of Type 2 diabetes mellitus (T2DM) has increased dramatically over the past 10 years in Malaysia due to the modernisation of the country. The most recent national health survey revealed that more than 15.2% of Malaysian adults are suffering from the diseases. Insulin treatment has been demonstrated to play a clinically significant role to improve glycaemic control among selected Type 2 diabetes mellitus (T2DM) patients. However, studies from several local hospitals showed that more than half of T2DM patients are reluctant to initiate insulin treatment. There is an increasing trend for the Malaysian healthcare sector to invest in understanding patients’ health experiences. This qualitative study focused on T2DM patients’ insights about their lived-experience of using insulin treatment as part of their diabetes management. This study aimed to understand the facilitators, which encourage patients to accept insulin treatment and also the psychological, social and behavioural barriers to effective diabetes management. Drawing on interview data with 37 participants, the three main barriers to initiate insulin treatment were worries about inability to handle using insulin, a sense of personal failure and negative perceptions of injections due to past experiences. The facilitators that encourage patients to accept insulin treatment were prior exposure to insulin injections, better side effect profile and wanting a better quality of life. However, there were many obstacles faced by T2DM patients when coping with insulin treatment such as the restriction of lifestyle and concerns about social acceptance. In general, knowledge of T2DM and insulin treatment are still lacking among the Malaysians interviewed in this study. There are still many distorted beliefs and misconceptions about insulin among T2DM patients. At the same time, patients’ concerns and beliefs regarding insulin use are greatly influenced by their experience and support from others. Many participants felt embarrassed and self-conscious when self-injecting insulin in public places. They felt that the Malaysian public often associate the use of injections to drug abuse. Social stigma is one key point, which leads to poor adherence to insulin treatment. Thus it is crucial to increase public awareness about insulin treatment in order to help these patients to be more comfortable about injecting, and also to encourage other people to be more open minded towards insulin treatment. Apart from raising public awareness, there is a need to empower T2DM patients with adequate knowledge through early, simplified, tailored education focusing on the disease nature and the role of insulin. Making them more aware of their health condition and the uses of modern insulin devices at an early stage will better prepare them mentally for insulin therapy.