Zhichao Wang, Tingyu Wang, Ran Tang, Dongtao Wang, Xianglong Zhang, Hiromi Nagaumi, Bowen Yang, Xu Ren, Jin Huang, Yingjie Zhang, Jiming Hao, Qiang Ma
Multiscale composites with engineered interfaces have emerged as a cornerstone in the development of next-generation biomedical materials. This review provides a comprehensive and structured overview of interface design strategies spanning nano-to macro-scales, emphasizing their role in modulating mechanical performance, biological signaling, and adaptive functionality. We categorize key approaches into three synergistic domains: hierarchical structuring for mechanical and cellular control, stimuli-responsive interfaces for dynamic biomedical functions, and bioinspired or living systems that mimic and integrate with biological environments. Advanced fabrication techniques-including additive manufacturing, surface nanofunctionalization, and layer-by-layer assembly-are reviewed alongside multiscale characterization tools for structural and interfacial analysis. We further link these interface strategies to a range of biomedical applications, such as osteochondral scaffolds, vascularized implants, antibacterial coatings, smart drug delivery carriers, and neural-integrated electronics. Biological interactions, including protein adsorption, mechanotransduction, and immune modulation, are explored to elucidate how engineered interfaces influence cellular fate and integration. Finally, we outline key challenges-such as manufacturing scalability, long-term biocompatibility, and regulatory approval-and propose forward-looking solutions enabled by AI-driven materials design and organ-on-chip validation. This review serves as a conceptual and technical roadmap for researchers developing multifunctional biomaterials through the lens of multiscale interface engineering.