A recent review by a collaborative team from Sun Yat-sen University and Jinan University systematically summarizes the latest advances in biomacromolecule-loaded microneedles for treating various major diseases. The article details the design of functional microneedles with specific structures to overcome drug delivery barriers in the skin, heart, and blood vessels, thereby improving therapeutic outcomes. It also discusses key challenges in industrial-scale manufacturing and clinical translation, proposing forward-looking solutions.