When a person is first diagnosed with diabetes, one of the first questions voiced is "What can I eat?" Many will then attend self-management education classes to learn more - a time when, unsurprisingly, adherence to the diet is at an all-time high. Over time however, that adherence declines, with research suggesting that among people with diabetes, long-term adherence to the prescribed diet rarely increases above 50%. Why might this be the case when the consequences of not adhering are clearly reiterated by every health professional they see? Contrary to popular belief, adherence to the diet is impacted by more than just inadequate knowledge or poor food choices. As health professionals, we have a responsibility to appreciate this complexity. Predicting who will be adherent to the diet is very difficult. However current research indicates four factors affecting adherence to the diet for diabetes that I want to discuss - ones that might surprise you.