Medical image segmentation is one of the fundamental problems for artificial intelligence-based clinical decision systems. Current automatic medical image segmentation methods are often failed to meet clinical requirements. As such, a series of interactive segmentation algorithms are proposed to utilize expert correction information. However, existing methods suffer from some segmentation refining failure problems after long-term interactions and some cost problems from expert annotation, which hinder clinical applications. This paper proposes an interactive segmentation framework, called interactive MEdical segmentation with self-adaptive Confidence CAlibration (MECCA), by introducing the corrective action evaluation, which combines the action-based confidence learning and multi-agent reinforcement learning (MARL). The evaluation is established through a novel action-based confidence network, and the corrective actions are obtained from MARL. Based on the confidential information, a self-adaptive reward function is designed to provide more detailed feedback, and a simulated label generation mechanism is proposed on unsupervised data to reduce over-reliance on labeled data. Experimental results on various medical image datasets have shown the significant performance of the proposed algorithm.