An anaerobic fluidized bed membrane bioreactor (AFMBR) is a new and effective method for energy-efficient treatment of low strength wastewater, but the factors that affect performance are not well known. Different inocula and acclimation methods of the granular activated carbon (GAC) used in the reactor were examined here to determine their impact on chemical oxygen demand (COD) removal and microbial community composition of domestic wastewater-fed AFMBRs. AFMBRs inoculated with anaerobic digester sludge (D) or domestic wastewater (W) and fed domestic wastewater, or inoculated with a microbiologically diverse anaerobic bog sediment and acclimated using methanol (M), all produced the same COD removal of 63 ± 12% using a diluted wastewater feed (100 ± 21 mg L−1 COD). However, an AFMBR with GAC inoculated with anaerobic digester sludge and acclimated using acetate (A) showed significantly increased wastewater COD removal to 84 ± 6%. In addition, feeding the AFMBR with the M-acclimated GAC with an acetate medium for one week subsequently increased COD removal to 70 ± 6%. Microbial communities enriched on the GAC included Geobacter, sulfur-reducing bacteria, Syntrophaceae, and Chlorobiaceae, with reactor A having the highest relative abundance of Geobacter. These results showed that acetate was the most useful substrate for acclimation of GAC communities, and GAC harbors unique communities relative to those in the AFMBR influent and recirculated solution.