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Suboptimal gestational weight gain has been associated with adverse perinatal and maternal outcomes, including increased risk of non-communicable diseases later in life. This study aimed to determine the proportion and determinants of suboptimal GWG. A cross-sectional study was conducted among 475 pregnant women in Selangor between January and March 2020. The study included all pregnant women at their second or third trimester who fulfilled the inclusion and exclusion criteria. A multistage sampling was applied. The GWG adequacy was based on recommendations from the Institute of Medicine (2009). Multinomial logistic regressions were used for data analysis. Out of the 475 respondents, 224 (47.2%) pregnant women had inadequate GWG, 142 (29.9%) had adequate GWG, and 109 (22.9%) had excessive GWG. Multinomial logistic regression showed that having diabetes in pregnancy (AdjOR 2.24, 95% CI: 1.31, 3.83, p = 0.003), middle (M40) monthly household income (AdjOR 2.33, 95% CI: 1.09, 4.96, p = 0.029), low (B40) monthly household income (AdjOR 2.22, 95% CI: 1.07, 4.72, p = 0.039), and an obese pre-pregnancy BMI (AdjOR 2.77, 95% CI: 1.43, 5.35, p = 0.002) were significantly associated with inadequate GWG. Overweight (AdjOR 5.18, 95% CI: 2.52, 10.62, p < 0.001) and obese pre-pregnancy BMIs (AdjOR 17.95, 95% CI: 8.13, 36.95, p < 0.001) were significantly associated with excessive GWG. Improving maternal and perinatal outcomes requires targeted interventions focusing on these modifiable determinants.