Let M be a smooth 4-manifold underlying some del Pezzo surface of degree \(d \ge 6\) . We consider the smooth Nielsen realization problem for M: which finite subgroups of \({{\,\textrm{Mod}\,}}(M) = \pi _0({{\,\textrm{Homeo}\,}}^+(M))\) have lifts to \({{\,\textrm{Diff}\,}}^+(M) \le {{\,\textrm{Homeo}\,}}^+(M)\) under the quotient map \(\pi : {{\,\textrm{Homeo}\,}}^+(M) \rightarrow {{\,\textrm{Mod}\,}}(M)\) ? We give a complete classification of such finite subgroups of \({{\,\textrm{Mod}\,}}(M)\) for \(d \ge 7\) and a partial answer for \(d = 6\) . For the cases \(d \ge 8\) , the quotient map \(\pi \) admits a section with image contained in \({{\,\textrm{Diff}\,}}^+(M)\) . For the case \(d = 7\) , we show that all finite order elements of \({{\,\textrm{Mod}\,}}(M)\) have lifts to \({{\,\textrm{Diff}\,}}^+(M)\) , but there are finite subgroups of \({{\,\textrm{Mod}\,}}(M)\) that do not lift to \({{\,\textrm{Diff}\,}}^+(M)\) . We prove that the condition of whether a finite subgroup \(G \le {{\,\textrm{Mod}\,}}(M)\) lifts to \({{\,\textrm{Diff}\,}}^+(M)\) is equivalent to the existence of a certain equivariant connected sum realizing G. For the case \(d = 6\) , we show this equivalence for all maximal finite subgroups \(G \le {{\,\textrm{Mod}\,}}(M)\) .