We consider quantum mechanical gauge theories with sixteen supersymmetries. The Hamiltonians or Lagrangians characterizing these theories can contain higher derivative terms. In the operator approach, we show that the free theory is essentially the unique abelian theory with up to four derivatives in the following sense: any small deformation of the free theory, which preserves the supersymmetries, can be gauged away by a unitary conjugation. We also present a method for deriving constraints on terms appearing in an effective Lagrangian. We apply this method to the effective Lagrangian describing the dynamics of two well-separated clusters of D0-branes. As a result, we prove a non-renormalization theorem for the ν4 interaction.