Social media shapes how the public and health professionals access, share, and judge health information. Nursing digital influencers may strengthen health literacy and trust in primary care by disseminating evidence-informed content and correcting misinformation, yet their profiles and audience motivations are not well described.To characterize nursing digital influencers and analyze audience connection justifications related to dissemination of health information and confrontation of misinformation.Documental, cross-sectional quanti-qualitative study using public data from Instagram, Facebook, TikTok, X (formerly Twitter), and YouTube (July 2022 to December 2024). Eligible accounts were public profiles of nursing professionals identified as opinion leaders using the Flynn, Goldsmith and Eastman model, with professional status verified in the national registry; only profiles created before the COVID-19 pandemic were included. Variables (platform, follower volume, profile type, professional category, main theme) were summarized with frequencies; chi-square tests for trend used alpha=0.05. Connection-justification texts were analyzed in IRaMuTeQ (text analysis software) (similarity analysis with chi-square and Z-scores for word prominence).We identified 324 nursing digital influencers with a combined reach above 45 million followers. Most were registered nurses (91.4%), managed personal profiles (75.4%), and used Instagram (75.3%) (p<0.05 for trends). Nursing education was the most frequent main theme (31.2%), followed by general nursing (24.7%). Most total audience reach was concentrated among macro-influencers (500,000 to 1,000,000 followers). Two thematic domains emerged from connection justifications. Dissemination of health and nursing information included engagement with educational content, professional development, technical-practical guidance, and appreciation. Confronting misinformation included professional advocacy and identity, daily practice experiences, critique of devaluation and power, peer support, and legitimizing the influencer as a spokesperson. A central lexical cluster connected learning and professional interest to nursing identity and advocacy.The combination of high reach, educational focus, and explicit misinformation correction suggests that nursing influencers are relevant actors for primary care oriented health communication. Their legitimacy also underscores the need for ethical guidance and quality assurance for online health information.Nursing digital influencers can contribute to dissemination of reliable information and to confronting health misinformation. Collaborative strategies with primary care services and professional bodies may enhance health literacy and trust.