The demand for mealworms as food is expected to increase over the coming years globally due to the recent sector development; however, consumer acceptance could vary among countries, hence, identifying drivers towards insects as food could help to develop different strategies to increase consumer acceptance, based on the location. Thus, this study aimed to explore consumers’ motivations to accept or reject whole and processed mealworms (Tenebrio molitor) in Belgium, China, Italy, Mexico, and the US (N = 3006). To reach this aim, an online survey with two open-ended questions was performed and responses were categorized into semantic groups based on their meaning. We identified what motivates consumers among different acceptance levels (“Yes, because…”, “Yes, but…”, “Maybe if…”, “No, because…”), and cross-country differences were investigated using hierarchical cluster analysis. “Healthiness” was the most frequent driver to accept whole and processed mealworms, except in Italy. “Aversion” and “dislike” were the most important barriers that led to rejecting these products across all five countries. However, some country differences exist. For example, Italian consumers often reported different motivations to either accept or reject mealworms, e.g., by giving less importance to health-related aspects and by showing more aversion towards the insect compared to the other countries. Reported reasons to reject mealworms were common between the traditional and non-traditional insect-eating countries.