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Objective: To map and synthesize the available evidence on nurses' communication competencies and psychosocial care competencies in mental health management for older adults with type 2 diabetes mellitus (T2DM) and multiple chronic conditions (MCC), and to identify gaps in competency frameworks, training interventions, and assessment tools. Introduction: Older adults with T2DM and MCC experience disproportionately high rates of depression, anxiety, and diabetes-related distress. Nurses are positioned at the frontline of diabetes care but frequently report insufficient training and low self-efficacy in delivering psychosocial support. Despite increasing recognition of this competency gap, the scope and nature of nurses' communication and psychosocial care competencies in this specific clinical context have not been systematically mapped. Inclusion criteria: Studies involving registered or enrolled nurses caring for older adults aged ≥65 years with T2DM and at least one additional chronic condition; reporting communication competencies, psychosocial care competencies, mental health management, training interventions, or assessment tools. All study designs—quantitative, qualitative, mixed methods, and reviews—published between 2010 and 2026 were considered. Methods: This scoping review followed the Joanna Briggs Institute (JBI) methodology and the PRISMA-ScR guidelines. A systematic search was conducted across PubMed, CINAHL, Scopus, Web of Science, Embase, and PsycINFO. Two reviewers independently screened titles, abstracts, and full texts. Data were extracted using a standardized form and synthesized using descriptive and thematic analysis approaches. Results: A total of 17 studies were included. Four themes were identified: communication competencies in diabetes care; psychosocial assessment and emotional support; barriers and facilitators; and training interventions and assessment tools. Communication competencies included teach-back, active listening, motivational interviewing, and SBAR. Psychosocial care competencies included assessment, emotional support, and referral. Barriers included educational gaps, low self-efficacy, burnout, time constraints, and lack of reimbursement. Training interventions included simulation-based learning, motivational interviewing, and nurse-led psychological interventions. Assessment tools included PCCSAS and PSSE-N, but these have not been validated specifically in older adults with T2DM and MCC. Conclusion: The evidence on nurses’ communication and psychosocial care competencies in mental health management for older adults with T2DM and MCC remains fragmented. Existing competency frameworks rarely address multimorbidity and mental health simultaneously, and training interventions and assessment tools for this population require further validation. These findings identify critical gaps in the current evidence base and provide directions for future research, nursing education, and clinical practice.