Introduction: The purpose of this study was to assess the status of diabetes management among elderly people living in Isfahan nursing homes using the Donabedian framework in three parts: structure, process, and outcome.Methods: In 2018, the current descriptive-cross-sectional approach was used in 13 nursing homes in Isfahan. Data was collected using a dependable and valid research-created checklist that evaluated diabetes management through three components: organizational structure (8 dimensions and 33 items), processes (3 dimensions and 23 items), and outcomes (2 dimensions and 7 items). Data was collected by observing the equipment and human resources, interviewing key informants and nurses, reviewing documents, and collecting blood and urine samples under standard conditions.Results: Structure, process, and outcome mean scores were 34.5±2.6, 38.5±5.9, and 65.6±13.9, respectively. The highest and lowest structure scores were associated with "referral system" and "trained personnel," respectively; process scores were associated with "counseling and risk factor reduction" and "immunization," and outcome scores with "physical examination and history taking" and "documentation of laboratory results." The mean score of structure was found to have a direct relationship with process and outcome (p < 0.05). There was also a direct relationship (p <0.05) between the mean process and outcome scores. Linear regression analysis revealed that structure was a significant predictor of outcome (p = 0.01).Conclusions: The findings revealed some issues with the structure, process, and outcome of providing appropriate diabetes management care in nursing homes. To achieve positive results in this area, it is necessary to focus on the human resources, facilities, and equipment required to manage diabetes in nursing homes.