Background Obesity and type 2 diabetes mellitus (T2DM) are growing global health concerns associated with significant morbidity, mortality and increasing healthcare expenditures. Indigenous peoples are at higher lifetime risk of both and poorer health outcomes. This work aimed to explore the experiences of Indigenous who had undergone bariatric surgery. Methods We established relationships with Indigenous community leaders. A mixed methods scoping review of experiences and outcomes of Indigenous patients undergoing bariatric surgery was conducted. Guided by an Indigenous Elder, we gathered knowledge through Sacred sharing circles, ceremony and Traditional teachings in a decolonized way. Results Scoping review found Indigenous patients have poorer access to bariatric surgery with similar weight loss outcomes and strong motivators for pursuing bariatric surgery. Relationship building, community involvement, and honoring tradition are crucial when conducting research with Indigenous communities. Indigenous people undergoing bariatric surgery in Manitoba had positive experiences, strong motivators, and felt that more cultural supports were needed. Conclusion Bariatric surgery is an effective treatment for obesity and T2DM. Research with Indigenous communities to close gaps in health outcomes must be done in a good way, rooted in Indigenous methodologies. Indigenous patients have strong motivators for pursuing surgery, and have a desire for non-surgical, culturally relevant supports along the bariatric pathway. Culturally sensitive care is necessary for Indigenous patients in bariatric clinic settings.