Microwave (MW) medicine has emerged as a distinct interdisciplinary field, predicated on the unique capacity of non-ionizing electromagnetic radiation to penetrate deep-seated tissues and interact efficiently with biological dielectrics for diverse therapeutic and diagnostic applications. Despite its clinical establishment in tumor ablation and hemostasis, conventional MW interventions are largely constrained by non-selective macroscopic heating, leaving the intricate potential of non-thermal biophysical modulation underutilized. The integration of engineered biomaterials provides a transformative framework to bridge this gap, enabling the precise modulation of MW-tissue interactions at the micro- and nanoscale. This review systematically elucidates how rational material design via tuning dielectric and magnetic loss, band-gap engineering, and structural polarization expands MW medicine beyond bulk heating toward controlled biological regulation. We discuss mechanisms where biomaterials function as localized energy antennas to sharpen thermal gradients, as MW-dynamic sensitizers to induce reactive oxygen species generation, and as intelligent interfaces to regulate ionic homeostasis. Representative advancements are summarized across antitumor, antibacterial, and anti-inflammatory therapies, alongside innovations in high-fidelity thermoacoustic imaging. Furthermore, emerging frontiers in non-destructive tissue repair and neuromodulation are highlighted. This review critically examines the design principles and translational challenges of MW-based medical technologies by analyzing correlations between physicochemical parameters and specific biological outcomes. It is expected to advance MW medicine from empirically guided thermal interventions toward mechanism-driven, precision-targeted electromagnetic therapeutics.

Tumor-associated macrophages (TAMs) are pivotal regulators of the immunosuppressive tumor microenvironment and major contributors to resistance against conventional and immunotherapeutic interventions. Rather than eliminating TAMs, emerging strategies aim to functionally reprogram them toward an antitumor phenotype, a therapeutic objective uniquely enabled by the precise, transient, and non-integrating nature of mRNA, which allows reversible modulation without genomic risk. Recent progress in nanocarrier design has improved selective delivery to TAMs through both passive uptake and active targeting, with administration routes tailored to tumor location. Precise immunomodulatory interventions in macrophages, accomplished by mRNA payloads designed to induce pro-inflammatory polarization, enhance phagocytosis, or block immunosuppressive signals, thereby remodel the tumor immune microenvironment and generate synergy with established treatments. Future efforts might concentrate on macrophage heterogeneity, carrier immunogenicity, and scalable formulation development to advance clinical translation, not only in cancer but also in other diseases shaped by dysregulated macrophage function.