Adults with multimorbidity (OAwM) health conditions face complex self-management challenges for which digital health presents a promising solution. However, older adults are often seen as having lower digital competencies, with less engagement with digital health, leading to exclusion from digital health services and widening the digital divide. In investigating this divide, this systematic review identified the pre-use of digital technology as crucial to the design of inclusive digital technology for healthcare management in older adults. The review also systematically analysed barriers from older adults’ perspectives, highlighting the need to incorporate their views and involve them in the design process as a means to improve digital health adoption and address their unique health challenges.