Background <p>Malnutrition among older adults remains a critical concern. Nurses play a key role in its prevention, yet their self-efficacy in nutritional care is often overlooked.</p> Purpose <p>To identify classes of self-efficacy in nutritional care for older adults among nurses and determine key intervention targets for each class.</p> Method <p>A cross-sectional online survey was conducted between August and October 2024 using convenience sampling. A total of 510 nurses from different hospital grades in Jiangsu Province, China, completed a general information questionnaire and the Self-Efficacy Scale for Nursing Nutrition Care (SE-NNC). Latent profile analysis identified classes of self-efficacy, and two types of simulated interventions (weakened and enhanced) were conducted to explore key targets within each class.</p> Results <p>Three classes of SE-NNC were identified: low (15.9%), moderate (49.2%), and high (34.9%). Detecting early signs of nutritional changes in older adults and interpreting anthropometric and muscle condition indices were key intervention targets in the overall population. Organizing mealtimes to facilitate complete intake and supporting older adults with personalized meal interventions were the most critical targets in the low and moderate SE-NNC, respectively. Evaluating adherence to nutrition recommendations and detecting early nutritional changes were the main focus areas in the high SE-NNC.</p> Conclusion <p>Three distinct SE-NNC patterns were identified, with five key traits representing potential intervention targets for improving the self-efficacy of nurses in providing nutrition care for older adults.</p> Clinical trial number <p>Not applicable.</p>