The transformation of "medical advice" into "health behaviors" is a core challenge in primary care chronic disease management, as traditional one-way communication often fails to adequately address the difficulties patients face in maintaining behavioral changes in real life. Motivational Interviewing (MI) provides a significant framework for addressing this issue; however, existing MI practices are mostly implemented in research settings with relatively ample time, which creates a disconnect from the reality of Chinese primary care clinics characterized by short consultation times and heavy workloads. Based on this, this paper employs narrative literature review and theoretical integration analysis, combined with examples of primary care doctor-patient communication, to concretely explain the technical system of MI. This includes change talk and sustain talk, the four core foundational skills, the four stages of a session, the "relational-technical" dual-path mechanism model, and the four pillars of the MI spirit. Furthermore, based on an analysis of typical service scenarios and the longitudinal nature of primary care services, three adaptation strategies are proposed: capturing "MI moments" in daily outpatient clinics to embed "light-weight MI"; establishing "mini-MI" closed-loops during family doctor contract follow-ups; and promoting the shift of health education from "one-way preaching" to "group motivation stimulation", aiming to provide a reference for the practical implementation of MI in primary care chronic disease management. Future research should focus on advancing the construction of localized lightweight and mini-MI techniques, developing stratified and categorized MI training systems, and improving institutional supports and localized fidelity assessment tools to support the routine implementation of MI.