Insulin is a hormone whose efficacy in wound healing was recognised in the late 1920s. Research in subsequent years has confirmed its significant contribution to reducing inflammation, regulating oxidative processes, fibroblast proliferation, and enhanced collagen deposition and vascularization in a variety of experimental wound models. Intensive research is currently underway to develop materials that will provide effective stabilisation of insulin and allow its controlled diffusion rate. The aim of this review was to bring together research on the development of innovative wound care strategies based on insulin-enriched bioactive dressings. An analysis of the literature contained in bibliographic databases (Embase, Medline, PubMed, Cochrane Library) and published up to 30 June 2023 was performed. Keywords used were: dressing, polymers, insulin, stability, topical, local treatment, sustained release, diabetic ulcers, wound healing, and chronic wounds. The literature was analysed, which met the established conditions of the review. To date, there have been many promising studies on the development of insulin dressings. The results of the included basic and preclinical studies confirm that engineered polymeric matrices/scaffolds with insulin show high efficacy and good tolerability in topical wound treatment.