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During the Coronavirus disease of 2019 (COVID-19), the dissemination of false information on social media increased significantly. The examination of social factors influencing the proliferation of fake news related to COVID-19 necessitates exploration from various perspectives and dimensions. Our research surveyed 392 Pakistani social media consumers, employing a survey questionnaire method conducted through snowball sampling technique. We utilized SPSS 26.0 for descriptive statistics, Pearson correlation, and regression analysis. The mediation and moderation effects were tested using Andrew F. Hayes' Process program (V3.3). Our findings revealed that COVID-19-related fake news tends to spread through instant news sharing behavior, driven by socialization and entertainment motives, acting as mediating factors in the relationship between instant news sharing and the dissemination of false information. Altruism also plays a moderating role, playing a moderating role in the impact of instant news sharing on fake news sharing, and also playing a moderating role in the impact of socialization on fake news sharing. Employing a rational choice theory framework, our study identifies instant news sharing, socialization, entertainment, and altruism as key rational choices influencing the sharing of pandemic-related fake news among Pakistani social media users.