Abstract: Objective This study explores the essential factors during the consensus process in guideline development, aiming to improve the quality of the consensus process by providing methodological suggestions for enhancing standardization. Methods Semi-structured qualitative interviews were used to interview guideline leaders, working groups and consensus groups to explore the relevant factors affecting the credibility of the consensus and their views on the composition and process of the consensus method. Results The researchers interviewed 26 individuals. After summarization, 212 codes were deepened into five areas:establishment of a consensus group, patient participation, meeting moderator, preparation of consensus and the influencing factors of consensus. Summarized the three basic steps of constructing a consensus group and the 17 basic principles of the application of the consensus method. Conclusion In the future guideline development, it is recommended to increase the methodological training before the consensus process and the full participation of methodologists, encourage experts to treat differences reasonably, pay attention to the methodology and evidence materials. The process should involve openly disclosing the selection of consensus group members, increasing patient participation, and managing and reporting conflicts of interest to reduce bias and enhance transparency, reliability, and scientific rigor of consensus outcomes.