Purpose: This study aimed to examine the associations among diabetes technology satisfaction, self-efficacy, and quality of life in adolescents with Type 1 Diabetes (T1D). Design and methods: This descriptive, cross-sectional study included 235 adolescents with T1D registered at Family Health Centers in a provincial center in Turkey's Western Black Sea Region. Data were collected using the Diabetes Technology Questionnaire (DTQ), the Diabetes Management Self-Efficacy Scale, and the Kiddo-KINDL Quality of Life Scale. Results: The mean HbA1c was 9.05 +/- 1.38%. Insulin pump (+/- CGM) users demonstrated significantly higher technology satisfaction (118.9 vs. 90.3; F = 47.23, p < .01), better self-efficacy (58.3 vs. 76.4; F = 18.42, p < .01; lower scores indicate higher self-efficacy), and higher quality of life (112.3 vs. 92.5; F = 21.87, p < .01) compared to the MDI + SMBG group. Hierarchical regression identified self-efficacy as the strongest predictor of quality of life (beta = -0.39, p < .001), followed by DTQ score (beta = 0.30, p < .001). The model explained 37.2% of total variance, with modifiable psychosocial factors contributing 28.0%. Female adolescents showed lower self-efficacy and quality of life than males (p < .01). Conclusion: Self-efficacy emerged as the strongest independent predictor of quality of life, surpassing demographic, clinical, and technology-related variables. Advanced diabetes technology use was consistently associated with more favorable psychosocial outcomes. Application to practice: Pediatric nurses should integrate self-efficacy-enhancing strategies and gender-sensitive psychosocial support into diabetes education, while advocating for equitable access to advanced technologies. (c) 2026 Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies.