National Health and Morbidity Survey 2015 has shown an increment of obesity rate among Malaysian adults over the last two decades. This reamplifies the findings on metabolic syndrome (MetS) research which indicated the country MetS prevalence to be among world highest with abdominal obesity as the most common risk factor. MetS awareness is very low among Malaysians hence there is limited information on health related behavioural risk factors needed to constitute a cost-effective and multi-faceted lifestyle intervention. To address this gap, a qualitative investigation on nutrition and lifestyle behaviours among adults with MetS was done using a series of semi-scripted focus group (FG). Attendees of a private clinic, MONASH Medical Precinct, were invited to join the study. Prior obtaining consent, they were screened for MetS using the Harmonized Criteria. Selected participants were invited to join a recorded FG session. Recordings were transcribed and thematically analysed based on the Health Belief Model (HBM) using Nvivo software. Six FGs involving twenty-one participants (Mean age: 51±10.3 years old) were done to achieve saturation. All participants were found to have abdominal obesity and hypertension while 90% have more than three MetS risk factors. Six themes were reported to be significant motivations and barriers for good nutrition and lifestyle behaviours among adults with MetS. Three behavioural barriers includes 1) limited knowledge on general wellbeing; 2) unaware about MetS risk factors and outcomes; and 3) concerns on primary care services. Consequently, three behavioural motivations are 1) a confidential peer and social support system; 2) continuous referral and support following diagnosis; and 3) sense of responsibility to protect self, family and community. Findings from our study provide a relevant input for an effective construct of a lifestyle intervention and to improvise prevention strategies for Malaysian adults with MetS.