Objectives <p>This study aimed to examine the current practices and perceived roles of community pharmacists in diabetes care and prevention services in Malaysia, and to identify organizational and professional characteristics associated with service provision.</p> Methods <p>A self-administered questionnaire-based cross-sectional study was carried out among community pharmacists in Malaysia. A stratified convenience sampling technique by regions was applied, and subsequent analyses included descriptive statistics, chi-square tests, binary logistic regression, and modified Poisson regression.</p> Key findings <p>A total of 339 (94.6%) participants responded, with 80.2% (<i>n</i> = 272) perceiving diabetes care and prevention services as a community pharmacist’s role. Yet only 43.1% (<i>n</i> = 146) reported frequent involvement in such services, indicating a substantial perception-practice gap. Services such as blood glucose monitoring (77.6%, <i>n</i> = 263), laboratory result explanation (74.0%, <i>n</i> = 251), and anti-diabetic medication preparation (65.8%, <i>n</i> = 223) showed smaller discrepancies. Whereas prescription screening and medication adherence support were less frequently practiced despite high perceived importance. Pharmacies owned by single or group proprietors (OR: 9.657, 95% CI: 2.352–39.649), those operating longer hours, and those serving a higher volume of customers purchasing oral anti-diabetic medications (OR: 11.224, 95% CI: 5.35-23.546) were more likely to provide diabetes care and prevention services.</p> Conclusion <p>Although community pharmacists in Malaysia largely recognize their role in diabetes care and prevention, actual service delivery remains limited. The findings highlight the importance of organizational and operational factors in shaping service provision and underscore the need for implementation-focused strategies to support the integration of community pharmacists into diabetes care frameworks.</p>