Joey Wendle replaced Diaz at third base in the starting lineup. Diaz left in the second inning of Monday's Game 3 win because of left foot soreness.
Diaz missed two months with a fractured left foot before being activated for the last game of the regular season.
He hit two solo home runs in the Rays' victory of the Oakland Athletics in last week's wild card game, but has yet to record a hit against the Astros in this series.
The Rays are facing elimination heading into Tuesday's game, down 2-1 in the series.