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Electronic devices are increasingly used to support self-management in adults with type 1 diabetes (T1DM). However, understanding patient perceptions and lived experiences is essential to ensure effectiveness, equitable accessibility, and sustained acceptance. This qualitative evidence synthesis explored how adults with T1DM perceive and experience electronic devices for self-management, focusing on benefits, barriers, and contextual factors influencing use. A systematic search across six databases was conducted using the Cochrane Qualitative and Implementation Methods Group approach. Qualitative studies published up to December 2024 were included. Data were analyzed using descriptive thematic synthesis and reported, following PRISMA and ENTREQ guidelines. Twenty-seven studies encompassing 522 participants were included. Eight key review findings emerged: Digital devices foster empowerment, encourage positive lifestyle changes, and could improve interactions with healthcare professionals. However, sustained use and engagement were shaped by contextual and emotional factors. Significant barriers include financial constraints, technical and usability problems, and limited continuous psychological and clinical support. Social support and integration into healthcare systems also influenced engagement. Electronic devices for T1DM self-management are complex socio-technical interventions whose potential depends on truly person-centered, equitable, supportive care. Trial Registration: PROSPERO: CRD42024572860.