Background and objective <p>Tele-ophthalmology is a beneficial technology for providing eye care to diabetic patients, given the ongoing upward trend of this disease across populations. Identifying barriers and facilitators that influence the adoption and implementation of tele-ophthalmology in diabetic eye care is crucial to increasing its utilization. This study aims to elicit and examine these factors using the existing literature to gain a comprehensive understanding of the determinants and to provide solutions that facilitate better adoption of this technology by various healthcare stakeholders, thereby optimizing clinical outcomes of diabetic eye care.</p> Materials and methods <p>This scoping review adhered to the PRISMA-ScR checklist. We searched the WoS, PubMed, Scopus, and Google Scholar databases through September 15, 2025, to conduct a comprehensive review of this topic. The study selection process was conducted in accordance with the PRISMA flowchart, and relevant data were extracted using a standardized data extraction form. A qualitative content analysis was conducted to identify the determinants of tele-ophthalmology adoption in diabetic eye care. The results were presented in tables and figures, along with a narrative synthesis of the qualitative data.</p> Results <p>After database searches, 257 studies were retrieved. By applying the eligibility criteria and conducting internet and manual searches in accordance with the PRISMA guidelines, seven articles were selected for data extraction and synthesis in this study. Thirty-eight barriers and 68 facilitators of tele-ophthalmology adoption in diabetic eye care were identified through a review of existing literature. The hurdles were classified into three themes: individual, organizational and managerial, and technological determinants. The facilitators were categorized into five themes: individual, organizational and managerial, technological, governmental, and cultural factors.</p> Conclusion <p>Identifying and accounting for the factors influencing tele-ophthalmology use is crucial to increasing its adoption among healthcare stakeholders across multiple areas, such as technological and organizational aspects. These factors can be used to develop a roadmap or guideline for stakeholders to enhance the adoption of this technology in healthcare settings.</p>