Introduction <p>In Australia, type 2 diabetes (T2D) and cardiovascular diseases (CVD) pose significant health problems in migrant communities. One such community is the Somali migrant community. There is limited research exploring experiences of self-management for the Somali community in Australia. Trust has been cited as one key factor in patients’ utilisation of health services and is central to their engagement with primary healthcare. This study aims to analyse how trust is formed in Somali adults living with T2D and/or CVD in Australia by exploring their experiences and perceptions of engagement with health professionals.</p> Methods <p>This qualitative study was conducted using four focus group interviews with 14 Somali adults living with T2D and/or CVD in Melbourne, Australia.</p> Results <p>The median age of participants was 58.5 (interquartile range 13) years; 10 were female and 4 were male. Findings from this study suggest that trust was based on interpersonal relationships and the perceived technical knowledge and skill of healthcare providers, such as their medical expertise or perceived suitability of prescribed medications. Participants had limited knowledge of the Australian primary healthcare system and services available, which influenced their level of engagement. This, along with sociocultural factors, low health literacy, and a lack of culturally appropriate resources for T2D/CVD management, further inhibited healthy lifestyle changes in participants.</p> Conclusion <p>Trust towards primary healthcare among Somali migrants in Melbourne living with T2D and CVD was impacted by knowledge, cultural, and systemic barriers. This study carries important implications in the field of primary healthcare to increase the accessibility of health services and design culturally tailored self-management guidelines for individuals to facilitate trust and engagement.</p>