Objective To explore the influencing factors associated with adherence to the 24-hour movement behavior guidelines among convalescent stroke patients and to provide evidence for developing individualized intervention strategies. Methods Purposive sampling method was used to select 15 convalescent stroke patients for semi-structured in-depth interviews. Based on the Capacity, Opportunity, Motivation-Behavior (COM-B) model as the theoretical framework, content analysis was utilized to analyze, induce, and refine the themes. Results The influencing factors of 24-hour movement behavior compliance in convalescent stroke patients included capability factors (insufficient cognitive level regarding 24-hour movement behavior, disease perception promoting self-management ability, and physical symptom limitations), motivation factors (perceived benefits of 24-hour movement behavior, strengthened health beliefs under the impact of illness, social enjoyment and emotional support, and negative behavioral inertia), and opportunity factors (family care support, high physical activity demands in occupational contexts, poor accessibility to environments and resources, lack of professional medical guidance, and heavy family financial burden). Conclusion The achievement of meeting 24-hour movement behavior guidelines among convalescent stroke patients was influenced by capability, opportunity, and motivation. These factors encompassed individual-level cognition, physical function, and psychological motivation, as well as external constraints such as the social environment and resource support. Healthcare professionals should comprehensively assess the multifaceted factors affecting compliance with these guidelines and develop targeted intervention strategies to promote the achievement of 24-hour movement behavior targets.