Objective: The paper is to understand the insured persons' tendency of medical insurance violations and identify the influencing factors, providing a reference for targeted governance of the insured persons' medical insurance violations. Methods: Based on the fraud diamond theoretical model, a questionnaire survey was conducted among 733 insured persons, and general descriptive statistics, single factor analysis, and multiple linear regression were used to show the insured persons' tendency of medical insurance violations. Results: The overall level of the insured persons' tendency to violate medical insurance regulations was 1.47±1.356 points, and 25.37% of the respondents showed a higher tendency to violate medical insurance regulations. The opportunity incentives of hidden rules exist in the pharmaceutical industry (β=0.107), the health pressure of the insured (β=0.148), the self-rationalization factors of borrowing social insurance cards is helping others (β=0.189) and medical insurance violations will not be discovered and punished (β=0.107), as well as the ability factors of knowing acquaintances in the medical institution-medicine-medical insurance system (β=0.157) and having the conditions, channels and tools to commit crimes (β=0.147) have a significant impact on the insured persons' tendency of medical insurance violations. Conclusion: It is necessary to strengthen multi-sector collaboration and intelligent supervision, improve the health level of the insured, promote the publicity of medical insurance law and moral education, correct the irrational knowledge of the insured, and strengthen the professional ethics of medical service providers.