Objective To explore the needs of patients with gestational diabetes mellitus (GDM) regarding the development of a diet health education game-based mini-program. Methods Employing a descriptive qualitative research approach, 15 pregnant patients with GDM were selected via purposive sampling from obstetrics clinics for semi-structured in-depth interviews. Data were analyzed and themes refined using content analysis. Results Four themes and nine sub-themes were identified, including routes of obtaining dietary education information in gestational diabetes (acquiring from professional medical teams, acquiring from social media platforms), attitudes towards electronic games (preferences for electronic games, attitudes towards diet education game mini-programs), expectations for the design of the game-based mini-program (balancing benefits and user-friendliness during application process, access to comprehensive and rich dietary information for gestational diabetes, provision of customized personalized dietary information), and challenges faced in gamified health education (vividness and professionalism of gamified scenarios, life-like game scenarios). Conclusion Before developing a diet-related health education game-based mini-program for GDM patients, medical staff should fully understand the users′ needs to offer a fun and feasible tool for dietary guidance.