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Consumer involvement in the co-design of diabetes self-management smartphone apps is vital. This scoping review explored how consumers are involved in the co-design processes and methods and approaches guiding this research.Our review was guided by Arksey and O'Malley's five-stage framework, PRISMA-ScR guidelines, and Witteman and colleagues' 11-item user-centered design (UCD-11) framework. We searched literature across five databases and examined types of consumer involvement in co-design and frequency of methods and approaches (i.e., co-design approaches, behavioral theories, and other frameworks), synthesizing findings in SPSS and Excel.Of the 14,206 initial items, 283 articles were included. Most studies were conducted in Asia (33.2%) and focused on type 2 diabetes (43.1%). All articles addressed at least one UCD principle, and prototype evaluation (UCD-3) was the most frequent (82.3%); 85.2% addressed iterative responsiveness (factor 2). Most articles (66.8%) did not report a particular method or approach; 20.5% used design-related approaches, with user-centered design being the most common (7.4%). Few articles (3.9%) utilized social cognitive theory.Overall, co-design activities were isolated by phase. Consumers were primarily involved in evaluating prototypes and had limited engagement in the early stages. Iterative responsiveness factor activities were underreported or limited in scope. The use of approaches, theories, and frameworks was inconsistent. Consumer involvement in the co-design of diabetes self-management apps is often limited to later phases, with minimal engagement during the critical preprototype phase. To enhance the relevance, effectiveness, and adoption of diabetes self-management apps, app designers should improve the reporting of co-design activities and engage consumers across all co-design phases.