The Canadian Aboriginal population has experienced a recent increase in chronic diseases. Type 2 diabetes prevalence rates have been recorded to be 3–5 times greater in Aboriginal populations than in non-Aboriginal populations. Childhood obesity, one of the most significant modifiable risk factors for developing type 2 diabetes, is often preventable with healthy lifestyle choices including exercise and diet. The main goal of this study was to develop and implement a locally and culturally adapted diabetes prevention program for youth in Rapid Lake, an Algonquin community in Quebec, Canada. Using focused ethnography and participatory research principles, the study progressed in four phases. Data collection involved interviews, focus groups, and observations. Thematic analysis was iterative. Findings include three main themes: 1) There was a contradiction between adult assumptions about what youth knew and what youth really knew about diabetes; 2) youth were highly receptive to interactive programming; and 3) youth took on the role of teacher for adult community members. Challenges and rewards to program development were also identified. The participatory approach employed during this project resulted in local Aboriginal youth and community worker empowerment, and will hopefully ensure the continuation of primary prevention diabetes program development and implementation within the community.