The development of wet adhesives capable of bonding in aqueous environments, particularly for hard tissues such as bone, tooth, and cartilage, remains a significant challenge in material chemistry and biomedical research. Currently available hard tissue adhesives in clinical practice lack well-defined wet adhesion properties. Nature offers valuable inspiration through the adhesive mechanisms of marine organisms, advancing the design of bioinspired wet adhesives. Beyond biomimetic approaches, alternative strategies have emerged for the design of wet adhesives. This review systematically summarizes the current design strategies for wet adhesives, focusing on their applications to hard tissues. Then, the unique chemical, physical, mechanical, and biological requirements for wet adhesives applied to hard tissues are also discussed. The importance of understanding natural adhesion mechanisms and the need for high-performance materials that can meet the complex demands of hard tissue adhesion in a complex and delicate physiological microenvironment are highlighted. Finally, this review clarifies the future research directions that can further facilitate the clinical application of wet adhesives for hard tissues. STATEMENT OF SIGNIFICANCE: The significance of this review lies in its comprehensive analysis of wet adhesives for hard tissues, a field that has been largely overlooked despite its critical importance in biomedical applications. The insights gained from studying natural adhesives and the translation of these mechanisms into synthetic materials have the potential to revolutionize medical procedures involving hard tissue repair and regeneration. This review meticulously addresses the distinct challenges and specific requirements of hard tissue adhesives, providing an exhaustive roadmap for researchers striving to develop wet adhesives that can endure the demanding physiological conditions inside the human body. In doing so, it aims to facilitate the transition from laboratory findings to practical clinical applications.