Dish antenna is used to create communication between earth station and on flight orbiting satellite. Its application as distributed mobile nodes in telemedicine ensures that information is remotely communicated between healthcare personnel and patience for efficient healthcare service delivery. An existing command and positioning control based on Proportional-Integral-Derivative (PID) control technique for satellite dish antenna mounted on distributed mobile telemedicine vehicles cruising within Nigeria such that antenna nodes communicate via Nigcomsat-1R has shown to suffer from performance degradation as time delay increases. Also, in a situation where certain parameters or operating conditions of the system varies and uncertainty caused by nonlinearity effect occurs, a conventional PID controller will not be able to change its gains or parameters to adapt or adjust with the variations or changes in system dynamics. This work has presented enhancing the performance of a telemedicine node using intelligent based adaptive mechanism to address these challenges. In order to achieve this, the dynamic model of satellite dish antenna positioning control system for distributed mobile telemedicine nodes in Nigeria was determine, an adaptive control method was developed, and an intelligent control model based fuzzy logic control (FLC) algorithm was developed and integrated with the adaptive control algorithm. The developed intelligent based adaptive controller was introduced into the satellite dish antenna positioning control system and the performance of the proposed satellite dish antenna positioning control system for distributed mobile telemedicine nodes was analysed in MATLAB/Simulink simulation environment. With the conventional system exhibiting very high rise time and settling time of 85.9896 s and 153.6396 s due to associated communication delay, the designed intelligent based adaptive control system was able to achieve rise time of 8.2215 s and settling time of 16.1065 s, which indicated an improvement on rise time and settling time. Comparison evaluation revealed that designed system offered improved smooth control process and fine overshoot performance over existing classical PID control systems. Generally the performance of the designed antenna position control system in the telemedicine application was optimized using model reference adaptive control (MRAC) augmented FLC algorithm called MRAC-FLC. The significance of the transient response time performance obtained by the MRAC-FLC designed in this work is that it will be able to offer faster response and enhanced the tracking and stabilisation of the antenna positioning process during satellite communication for efficient telemedicine healthcare services.