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Aim: Improper administration of insulin and medication errors related to insulin use can have serious consequences. The knowledge and understanding of patients with diabetes in Bangladesh regarding their insulin utilization were explored. Subjects and methods: Face-to-face semi-structured interviews were conducted among patients with diabetes (n = 390) from four districts, of which 30.0% were insulin users. The interviews collected information on socio-demographic variables, diabetes-related information, knowledge of diabetes, and knowledge of insulin use. Results: The majority of participants correctly responded that patients with diabetes might need to receive insulin treatment (91.5%), that insulin administration may need to be stopped while blood sugar levels are low (61.70%), and that insulin use is allowed by religious beliefs (97.20%). However, only a minority were aware that insulin therapy reflects the last available treatment step for patients with diabetes (34.10%) and that people with diabetes need to preserve the regularity of their food habits while taking insulin (17.90%). The mean score of insulin use-related knowledge was 3.02±0.73 (out of 5) in the total sample, with insulin users having significantly higher scores than non-insulin users (3.19±0.69 vs. 2.95±0.74; p= 0.003). Current residence, monthly family income, and visiting doctors in the past six months were significant predictors of insulin use knowledge. Conclusions: This exploratory study highlights the mixed knowledge of insulin use among Bangladeshi patients with diabetes and emphasizes the need for health education campaigns that provide comprehensive coverage of insulin therapy.