Institutional support for social work case management in services for adults with intellectual disabilities has attracted limited literature attention globally. This study aims to explore how social workers in services for adults with intellectual disability make sense of institutional support in the domain of case management. Through purposive sampling, 13 social workers employed in this service setting were invited to attend in-depth interviews to share their views on institutional support for case management. Five themes were developed through qualitative data analysis: ‘ A big dinner without a main course’, ‘“ Tip Si” but not explicit’, ‘ Towards inclusion’, ‘ Fulfilling the requirement’ and ‘ Surviving the “ unfair” salary system’. These findings indicate that the current institutional surrounding is not well-suited to the case management practice, and social workers also passively participate in institutional design. Furthermore, this study implies a coordination between institutions and social workers could enhance case management practice in services for adults with intellectual disabilities. The future academic attention could be paid to the more in-depth context of institution–practice relation in case management and how the service environment shapes social workers’ case management practice.