ObjectivesThe prevalence of non-alcoholic fatty liver disease (NAFLD) in China has significantly increased due to changing lifestyles and rising obesity rates. Effective self-management behaviours are crucial for reversing NAFLD. This study aimed to assess the current self-management status and the influencing factors among the Chinese NAFLD population.DesignA cross-sectional study.SettingThis was a study conducted between 30 May 2022 and 30 May 2023 at a tertiary care hospital.ParticipantsA total of 380 patients diagnosed with NAFLD were included in this study. NAFLD patients included in this study were diagnosed by FibroScan and had a controlled attenuation parameter ≥248 dB/m.Primary outcomes and measuresThe primary outcomes were self-management, demographic characteristics and clinical features of patients with NAFLD. Self-management-related domains were assessed using the self-management questionnaire of NAFLD.ResultsThe study included 380 patients with an average age of 42.79±13.77 years, with 62.89% being male. The mean score on the self-management scale was 80.92±18.31, indicating a low level of self-management behaviours. Among the five dimensions of the self-management scale, lifestyle management received the highest score (10.68±2.53), while disease knowledge management received the lowest score (9.29±2.51). Furthermore, gender (β=0.118, p=0.009), education level (β=0.118, p=0.010), body mass index (BMI) (β=−0.141, p=0.002) and sleep quality (β=0.387, p<0.001) were found to influence the self-management behaviours of patients to some extent.ConclusionsThis cross-sectional survey in China revealed impaired self-management behaviours among adults with NAFLD. The study identified significant associations between self-management behaviours and gender, education level, BMI and sleep quality. Healthcare providers should focus on optimising the care of NAFLD patients to enhance their self-management behaviours.