Background <p>Effective communication plays a crucial role in gestational diabetes mellitus (GDM) management, yet little research has examined whether healthcare professionals (HCPs) use motivational statements that align with patient preferences. This study investigates the alignment between the motivational statements used by HCPs and those preferred by women with GDM, applying self-determination theory (SDT) as a framework and using qualitative as well as quantitative techniques for analysing results.</p> Method <p>One hundred twenty-six pregnant women with GDM and 21 HCPs rated 27 motivational statements categorized into autonomy, competence, and relatedness components of SDT. Differences in statement ratings between groups were analysed using Mann-Whitney <i>U</i> tests with Bonferroni correction. A chi-square test was used to assess discrepancies between statements used by HCPs and statements written by patients. Spearman’s correlations, Kruskal-Wallis tests, and Mann-Whitney <i>U</i> tests were used for associations between statement ratings and demographic characteristics (BMI, age, education level, history of GDM, obstetric history).</p> Results <p>The chi-square test revealed a significant misalignment. Women with GDM preferred competence-focused statements, whereas HCPs emphasized autonomy (<i>χ</i>²(2) = 6.228, <i>p</i> = 0.044). No significant associations were found between statement ratings and demographic variables.</p> Conclusion <p>The study highlights the need for better alignment between HCPs’ communication and patients’ needs to enhance their sense of competence, which could improve adherence to treatment recommendations.</p>