The group of older adults living alone has become larger, more complex, and more heterogeneity, with the change of family structure, the aging of parents with only child, the increase of migration frequency and spatial distance, and the change of values. We use the data of “Survey on Older Adults Aged 70 and Above Living Alone in Urban China” to analyze the health-related quality of life among older adults living alone. We find that older adults with different family types have significant differences in health-related quality of life, such as body health, mental health, and social adaptation. One with children and the spouse has the worst quality of body health; one with children but without spouse has the worst quality of mental health; the one without children and spouse has the worst quality of social adjustment. It is suggested to establish and improve the information database of the older adults living alone in the community, and provide targeted care services and classified security in the community. The government should give older adults living alone with children and spouses some help to improve the quality of body health, such as family support program, neighborhood visits and emergency services. The government should give older adults living alone with children but without spouses some help to improve the quality of mental health, such as providing spiritual comfort, “pairing” help and psychological counsel services. The government should give older adults living alone without children and spouses some help to improve the quality of social adaptation, such as constructing harmonious neighborhoods, encouraging social participation and improving life satisfaction.