A literature review was undertaken in 2019 to review research into the effectiveness of peer support in chronic disease self-management. As with an earlier literature review, we found the results disappointing due to poor reporting and poor research design. Lack of information on training of peer supporters, unrealistically short timeframes to produce changes in health behaviors, and lack of any theoretical underpinning of the research design contributed to rating randomized controlled trials as poor to medium quality evidence. At the same time, systematic reviews consider peer support as effective, arguing that improved research design and evaluation would demonstrate this. This article discusses the need to examine more closely the contribution of peer support to chronic disease care as well as considering how research methods might more closely reflect that contribution and provide better evidence of the value of peer support to both participants and the health system.