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Although extracellular vesicles (EVs) can convey regenerative signals and engineered cargo, therapeutic performance is ultimately determined by how a wound\u2010contact material preserves, presents, and releases them. This review reframes EV\u2010based treatment as the programming of an EV\u2013biomaterial interface. It relates wound barriers to cargo function; compares donor\u2010cell engineering, post\u2010isolation loading, surface modification, EV mimetics, and hybrid systems; and examines how composition, crosslinking, architecture, adhesion, mechanics, degradation, and stimulus responsiveness govern local exposure. Preclinical and emerging clinical evidence is evaluated alongside product\u2010defining measurements, including EV identity and purity, cargo content and encapsulation efficiency, removal of free cargo, recovery, release, potency, safety, sterility, and batch consistency. The analysis shows that added functional complexity is not inherently advantageous unless each component is mechanistically necessary and quantitatively controlled. A barrier\u2010matched, fully characterized interface therefore offers a rigorous basis for developing reproducible and clinically testable EV\u2010enabled wound therapeutics.<\/jats:p>","DOI":"10.1002\/adhm.71859","type":"journal-article","created":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T06:07:52Z","timestamp":1792562872000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Programming Extracellular Vesicle\u2013Biomaterial Interfaces for Diabetic Wounds: Barrier\u2010Matched Design and Translational Criteria"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-8364-0941","authenticated-orcid":false,"given":"Baoting","family":"Wu","sequence":"first","affiliation":[{"name":"Institute of Life Sciences &amp; Biomedical Collaborative Innovation Center of Zhejiang Province Wenzhou University  Wenzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-9210-7911","authenticated-orcid":false,"given":"Jing","family":"Ruan","sequence":"additional","affiliation":[{"name":"Key Lab of Biohealth Materials and Chemistry of Wenzhou Wenzhou University  Wenzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-3248-8279","authenticated-orcid":false,"given":"Ke","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Nephrology The First Affiliated Hospital of Wenzhou Medical University  Wenzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-6093-2372","authenticated-orcid":false,"given":"Xinlu","family":"Wang","sequence":"additional","affiliation":[{"name":"College of Life and Environmental Science Wenzhou University  Wenzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-1700-2681","authenticated-orcid":false,"given":"Si","family":"You","sequence":"additional","affiliation":[{"name":"College of Life and Environmental Science Wenzhou University  Wenzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-2621-2711","authenticated-orcid":false,"given":"Rongbing","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering City University of Hong Kong  Hong Kong Hong Kong SAR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-9657-8324","authenticated-orcid":false,"given":"Hanbing","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Biotechnology The University of Hong Kong  Hong Kong Hong Kong SAR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zongyun","family":"He","sequence":"additional","affiliation":[{"name":"Department of Hand and Foot Surgery Yiwu Central Hospital the Affiliated Yiwu Hospital of Wenzhou Medical University  Yiwu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-1707-6633","authenticated-orcid":false,"given":"Qinsi","family":"Yang","sequence":"additional","affiliation":[{"name":"Wenzhou Institute University of Chinese Academy of Sciences  Wenzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3900-5135","authenticated-orcid":false,"given":"Wei","family":"Wu","sequence":"additional","affiliation":[{"name":"Key Laboratory for Biorheological Science and Technology of Ministry of Education Bioengineering College of Chongqing University  Chongqing China"},{"name":"JinFeng Laboratory  Chongqing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7747-9951","authenticated-orcid":false,"given":"Da","family":"Sun","sequence":"additional","affiliation":[{"name":"Institute of Life Sciences &amp; 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