Background <p>Obesity is a growing global health issue, linked to chronic conditions like type 2 diabetes, hypertension, and cardiovascular diseases. Nursing staff could play a significant role in managing obesity, with telemedicine being a potentially effective tool for monitoring weight and caloric intake. However, the effectiveness of telemedicine-based nursing interventions in managing obesity and overweight remains unclear.</p> Objective <p>This systematic review with meta-analysis aimed to evaluate the effectiveness of nursing telemedicine interventions in managing overweight and obesity in adults.</p> Method <p>This review followed PRISMA guidelines and involved a literature search in Scopus, PubMed, and Web of Science. Eligible studies were in English, involved adults with a BMI over 25, and evaluated nursing-led telemedicine interventions (non-randomized and randomized controlled studies). Study quality was assessed using the Down and Black checklist. A random-effects model was used for the meta-analysis.</p> Results <p>Four moderate-quality articles were included. The nursing-led telemedicine interventions, delivered through digital platforms, mobile apps, and remote monitoring, focused on health education and motivational strategies to promote self-regulation and dietary improvements. The meta-analysis showed that, compared to traditional approaches, nursing-led interventions resulted in an average weight loss of 2.59&#xa0;kg (95% CI: − 3.09 to − 2.08), a reduction of 1.05&#xa0;kg/m² in BMI (95% CI: − 1.50 to − 0.60), and a decrease of 2.52&#xa0;cm in waist circumference (95% CI: − 2.96 to − 2.09).</p> Conclusion <p>Nursing telemedicine interventions are effective in promoting short-term weight loss and lifestyle changes. However, further research is needed to assess long-term effects and the impact of different interventions.</p>