Background <p>Overweight and obesity among women of childbearing age have become a major public health challenge affecting reproductive health worldwide. Excessive gestational weight gain and obesity during pregnancy substantially elevate the risk of gestational complications, particularly gestational diabetes mellitus (GDM), which poses threats to maternal and infant safety. Consequently scientific and effective intervention strategies for gestational weight management are urgently required.</p> Methods <p>Pregnant women at high risk for GDM who met the inclusion and exclusion criteria were enrolled in the study. Participants were allocated into an intervention group and a control group based on their preference. The intervention group received digital therapy management, whereas the control group received routine gestational care. Intervention effectiveness was assessed based on appropriate gestational weight gain (GWG), GDM incidence, and adherence.</p> Results <p>A total of 700 pregnant women at high risk for GDM were included, comprising 504 in the intervention group and 196 in the control group. Baseline characteristics were generally comparable between the groups, although significant differences were noted in gravidity, parity, and educational level. A higher proportion of participants in the intervention group achieved appropriate GWG during the second and third trimesters compared with in the control group, with a statistically significant between-group difference in the third trimester (<i>P</i> = 0.047). No statistically significant difference in the incidence of GDM was observed between the two groups.</p> Conclusions <p>Digital therapeutics during pregnancy effectively improved gestational weight management, with greater benefits observed over time. However, this improvement did not reduce GDM incidence.</p> Trial registration <p>Chinese Clinical Trial Registry, ChiCTR2300071496, registered 16 May 2023.</p>