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Background Family support is crucial in the care of elderly patients with diabetes. Pharmacists have proven to play an important role in assisting patients to achieve goals of drug therapy. However, more information is needed to evaluate the potential benefits of family-based intervention through a mobile application by pharmacists in the elderly diabetes patients.Objective To evaluate the influences of family support-based intervention using a mobile application on glycaemic control and diabetes control-related outcomes in the older adults with diabetes. Setting A hospital in the south of Thailand.Method A randomised controlled trial was conducted with 9 months of follow-up. Family members in the intervention group (n = 78) received diabetes educational courses and encouragement via a mobile application from pharmacists to help their elderly relatives with diabetes in self-management tasks. The control group received usual care (n = 79). Main outcome measure Glycosylated haemoglobin (HbA1c).Results As compared to baseline, significant improvements were observed in the intervention patients for HbA1c, blood pressure, family behaviour in diabetes care, diabetes knowledge, self-management practices and medication adherence (P < 0.001). The intervention group showed greater decline in HbA1c levels relative to the control group (-0.97% vs. -0.12%; P = 0.001). Significant differences between groups for changes in blood pressure levels including scores of family behaviour, diabetes knowledge, self-management and medication adherence were found (P < 0.001), with the intervention group showing greater improvement. Conclusion Family support intervention via a mobile application by pharmacists is beneficial to diabetes care for the elderly. Trial registration number: TCTR20200615001 (date 13 June 2020, retrospectively registered).