Background <p>Few studies have focused on the longitudinal monitoring of plantar pressure, which was critical for preventing diabetic foot ulcers and dynamically changes with care conditions.</p> Objective <p>We conducted a 15-month longitudinal investigation on dynamic plantar pressure in Chinese patients with type II diabetes to elucidate the temporal features of pressure distribution during daily care.</p> Methods <p>Forty-one patients with type II diabetes underwent three foot pressure assessments at 3- to 4-month intervals. Their diabetic peripheral neuropathy scores were evaluated during each assessment. The first to fifth metatarsals and heel regions of both feet were measured using the Footscan pressure plate. Pressure variation over time was analyzed by Repeated-Measures ANOVA and a map of pressure transfer was depicted within two measurements.</p> Results <p>Significant time effects were only observed in the left fifth metatarsals region (<i>F</i> = 3.731,&#xa0;<i>p</i> = 0.028) with a statistically significant difference in plantar pressure of the fifth metatarsal between the first and second measurements (<i>p</i> = 0.013). The <i>P</i>^T (i.e., the overall effect of time) for other sites was not significant. Regarding pressure transfer, a significant medial-to-lateral shift was observed in both feet, while transfer patterns varied between the first and second measurements, as well as between the second and third measurements.</p> Conclusion <p>Overall, this longitudinal analysis elucidated that there existed dynamics change of plantar pressure in diabetes patients; thereby, periodic monitoring was necessary, and it was important for the prevention and management of diabetic foot ulcers. Meanwhile, integrating patient-specific factors with targeted interventions may enable precision-driven strategies for diabetic foot management, transitioning from reactive care to proactive risk mitigation.</p>