As a new type of drug delivery system, microneedle have received extensive attention in wound healing due to their penetrability, painlessness, and high drug delivery efficiency. However, microneedle are often unable to penetrate the skin completely due to the limitations of the skin's mechanical properties, resulting in low drug delivery efficiency during wound repair. Therefore, it is particularly important to optimize the multi-level structural design of microneedles. This article systematically summarizes the multi-level structural design of microneedles that promote wound healing, including the structural parameters of a single microneedle, microneedle array design, and microneedle system structural optimization. It also summarizes the research progress on the functional design of microneedle systems at various stages of wound repair. This paper reviews the current status and limitations of microneedle patch design, and provides theoretical guidance for the design of smart microneedle wound management/healing.