Objective: To explore the application effect of combined exercise intervention based on the hospital-community-family model on intrinsic capacity in elderly patients with diabetes mellitus complicated by chronic kidney disease. Methods: Using convenience sampling, 100 elderly patients with diabetes mellitus complicated by chronic kidney disease who received treatment in the endocrinology department of a tertiary A-level hospital from May 2024 to May 2025 were selected as the study subjects. They were randomly divided into an experimental group (50 cases) and a control group (50 cases) using a random number table method. The control group received routine health education and telephone follow-up, while the experimental group, in addition to the control group’s interventions, underwent combined exercise intervention based on the hospital-community-family model. Remote medical guidance was utilized to monitor and study the application effect of exercise intervention on intrinsic capacity in elderly patients with diabetes mellitus complicated by chronic kidney disease. Fasting blood glucose, 2-hour postprandial blood glucose, glomerular filtration rate, 6-minute walk distance, and scores in five dimensions of intrinsic capacity (exercise, cognition, psychology, vitality, and sensation) were measured before the intervention, at 4 weeks of intervention, and at 12 weeks of intervention for both groups. Results: Before the exercise intervention, there were no statistically significant differences (p > 0.05) between the two groups in terms of fasting blood glucose, 2-hour postprandial blood glucose, glomerular filtration rate, 6-minute walk distance, and scores across five dimensions of intrinsic capacity: mobility, cognition, psychology, vitality, and sensation. After 12 weeks of intervention, the experimental group demonstrated significantly higher scores than the control group in glomerular filtration rate, 6-minute walk distance, and the dimensions of mobility, cognition, and vitality within intrinsic capacity, with all differences being statistically significant (p < 0.05). Conversely, the experimental group showed significantly lower scores than the control group in fasting blood glucose, 2-hour postprandial blood glucose, and the psychological dimension of intrinsic capacity, with these differences also being statistically significant (p < 0.05). Conclusion: Continuous nursing care utilizing telemedicine based on a hospital-community-family model combined with exercise intervention can effectively enhance exercise tolerance and intrinsic capacity in elderly patients with diabetes mellitus complicated by chronic kidney disease, thereby improving their quality of life. The effectiveness of the intervention is positively correlated with the duration of the intervention.