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Excessive reactive oxygen species (ROS) in wounds impede repair by damaging proteins and nucleic acids, activating inflammation, and suppressing immunity. A growing body of evidence suggests that harnessing the high oxidative stress within the microenvironment and modulating ROS levels to overcome repair barriers has become a breakthrough in treating chronic diabetic wounds. Hydrogels, with excellent biocompatibility and designability, are key for intelligent ROS regulation. Here, the role of ROS in the progression of diabetic skin wounds is detailed, which includes inducing oxidative damage, exacerbating inflammation and immune imbalance, as well as degrading the extracellular matrix (ECM), hindering neovascularization, and inhibiting nerve repair. Then, the ROS\u2010regulating strategy based on the hydrogel platform is discussed. Engineered hydrogels adjust ROS levels via external stimulus such as light, ultrasound, and electricity, or the microenvironment of hyperglycemia, oxidative stress, and acidity in wounds, and even bidirectionally in specific spatiotemporal contexts. Furthermore, the therapeutic and repair potential of ROS\u2010regulated hydrogels in the healing process of diabetic wounds is outlined, the current deficiencies in the field of diabetic wounds treatment are addressed, and prospects for the future are proposed.<\/jats:p>","DOI":"10.1002\/adma.202512719","type":"journal-article","created":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T08:31:23Z","timestamp":1759307483000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":95,"title":["Hydrogel\u2010Based ROS\u2010Regulating Strategy: Reprogramming the Oxidative Stress Imbalance in Advanced Diabetic Wound Repair"],"prefix":"10.1002","volume":"38","author":[{"given":"Qiaoling","family":"Zhou","sequence":"first","affiliation":[{"name":"Department of Oral and Craniomaxillofacial Surgery Shanghai Ninth People's Hospital Shanghai Jiao Tong University School of Medicine Shanghai 200011 China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu","family":"Zhuang","sequence":"additional","affiliation":[{"name":"Department of Oral and Craniomaxillofacial Surgery Shanghai Ninth People's Hospital Shanghai Jiao Tong University School of Medicine Shanghai 200011 China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoling","family":"Deng","sequence":"additional","affiliation":[{"name":"Department of Oral and Craniomaxillofacial Surgery Shanghai Ninth People's Hospital Shanghai Jiao Tong University School of Medicine Shanghai 200011 China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weidong","family":"Jiang","sequence":"additional","affiliation":[{"name":"Department of Oral and Craniomaxillofacial Surgery Shanghai Ninth People's Hospital Shanghai Jiao Tong University School of Medicine Shanghai 200011 China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xudong","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Oral and Craniomaxillofacial Surgery Shanghai Ninth People's Hospital Shanghai Jiao Tong University School of Medicine Shanghai 200011 China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Changyong","family":"Yuan","sequence":"additional","affiliation":[{"name":"School of Stomatology Xuzhou Medical University Affiliated Stomatological Hospital of Xuzhou Medical University Xuzhou 221002 China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1900-9641","authenticated-orcid":false,"given":"Kaili","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Oral and Craniomaxillofacial Surgery Shanghai Ninth People's Hospital Shanghai Jiao Tong University School of Medicine Shanghai 200011 China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,10]]},"reference":[{"key":"e_1_2_11_1_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41574-022-00690-7"},{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2017.04.013"},{"key":"e_1_2_11_2_2","first-page":"62","volume":"330","author":"Armstrong D. 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