Objectives. Gestational diabetes mellitus remains a major public health challenge. This disease has serious adverse effects on the mother and pregnancy outcome. The objective of the study was to explore the perceptions of women diagnosed with gestational diabetes mellitus on how healthcare providers in the rural province of South Africa manage it. Methods. This qualitative study is part of a larger mixed-method study conducted in the public healthcare facilities of the Mopani district, Limpopo Province, South Africa. Purposive sampling was used to recruit 17 eligible women diagnosed with gestational diabetes mellitus, and all of them agreed to participate. Data was analysed using a thematic analysis approach. Results. Three main themes emerged from the findings: challenges in self-management of gestational diabetes mellitus; health systems support for gestational diabetes; and referral to a dietician. Conclusion. In conclusion, dietary habits adjustment, self-management of prescribed medicines, and referral to a dietician for nutrition therapy remain a concern. It is recommended that counselling and educational programs be developed and urgently improve the dietician referral rate.