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Highlights • Nurse-led models of initiating injectable therapy in primary care are successful. • Education to GPs and nurses can assist initiation of injectable therapy. • Nurse-led patient group education can support initiating injectable therapy., Aims To systematically identify and describe models of injectable therapy initiation for people with type 2 diabetes mellitus (T2DM) in primary care. Methods Eight electronic databases and the grey literature were searched. Studies examining models of injectable therapy initiation for adults with T2DM in primary care settings were included. Results Successful models included: 1) Nurse-led one-to-one approach; 2) Nurse-led group sessions; and 3) Providing education to GPs and nurses. Conclusions Few robust studies were found. Studied models were mainly in general practices, with limited evidence documented about starting people with T2DM on an injectable in the home setting.