Although game-based learning strategies have been used in mathematics education for a period of time, the potential for enhancing students' learning achievement and math self-efficacy is still being explored. Students need to face complex mathematics concepts and calculations in mathematics courses. Even though using games to learn mathematics may enhance students' motivation, without efficiently personalized learning guidance, students may not be able to learn well in games. Therefore, adaptive educational games provide opportunities to give students personalized learning content and guidance. The concept-effect relationship is an effective tool for the organization of learning material in developing adaptive diagnostic systems for detecting students' learning problems. In this study, a concept-effect relationship and an interactive game-based learning system were conducted as an effective tool for the organization of learning material in developing a diagnostic and remedial system for detecting students' learning problems. An experiment was conducted on an elementary school mathematics course to evaluate the effects of the proposed approach. The experimental results clearly show that the proposed approach not only improves the efficiency of learning achievement for students, but also enhances their learning attitudes and self-efficacy, and reduces their cognitive load in mathematics courses.