It is not clear how developmentally appropriate healthcare services for adolescents (11–15) and young adults (16–25) should be provided.Aims.First, to describe and understand the influence of diabetes upon psychosocial development and second, to highlight the implications for healthcare teams.Design.Given the heterogeneity of findings, lack of conceptual clarity and lack of quantitative measures, qualitative semi‐structured interviews were used, to define more clearly the constructs significant to young people.Methods.People aged 16–25 registered with one secondary care diabetes service, across two districts in north‐east England were contacted. Nineteen interviews were conducted and analysed using a Framework Approach.Results.Diabetes can impact upon personal identity and self‐concept. Peer support can buffer from negative effects, especially if young people control the disclosure of their diabetes. In coming to rely more on peers, participants continue to value the safe base of their family, especially at times of change and challenge. A key challenge appears to be coming to terms with risk and mortality.Conclusion.Health care services need to support young people with self‐care but must also understand and respond to the social and personal complexities of growing‐up with a long‐term health condition. Psychologists may have a role in promoting and supporting