Fostering the adoption of collective value propositions in ecosystems requires strategic leaders to overcome the liability of newness, particularly in highly regulated industries. This study examines the role of middle managers as strategic leaders in driving ecosystem development. We introduce the concept of middle managerial interface work defined as a set of micro-practices across cognitive, behavioral, regulatory, and political interfaces with external stakeholders. These practices enable middle managers to align diverse perspectives, secure support, and facilitate the co-adoption of new value propositions, thereby shaping ecosystems “from the middle out.” Using a multiple case study design, we analyze data collected over four years from six technology providers introducing digital innovations in the regulated healthcare sector. We develop a framework revealing how middle managers’ interface work, entailing mutual comprehension, action, approval, and backing from diverse stakeholders, drives the emergence and co-adoption of collective ecosystem value propositions. Our research bridges the gap between ecosystem and strategic leadership literatures, offering novel insights into the outward influence of middle managers on ecosystem dynamics. We contribute to our understanding of the unique role of middle managers’ interface work in ecosystem value proposition co-adoption. Theoretical and practical implications highlight how organizations can leverage middle managers as strategic leaders to navigate stakeholder complexity and achieve transformative outcomes in emerging ecosystems.
