<p>Polymers are crucial in promoting bone tissue engineering, presenting flexible solutions for bone repair and regeneration. Composite biomaterials combine two or more biomaterials to obtain specific properties tailored to patient-specific needs rather than using them separately. Due to their biocompatibility and biodegradability, they are excellent choices for producing scaffolds that replicate the body’s natural extracellular matrix. Scaffolds must possess non-hazardous characteristics like biodegradability and biocompatibility for the human body, along with essential mechanical behavior to provision body weight or fulfil other functions depending on the tissue type. Currently, the prevalence of bone disorders and defects due to tumour, injuries, microbial infections, and degenerative or inflammatory conditions is increasing. Thus, the advancement of bone repair and replacement has progressed alongside the enhancement of orthopedic technologies and high-quality biomaterials. However, advancements, major challenges in bone tissue engineering remain, such as the generation of unfavourable degradation by-products, limited mechanical strength, and inadequate cellular interactions. This review focuses on key aspects of scaffold design, including biodegradability, mechanical performance, fabrication approaches, and the choice of biomaterials. Further evaluates scaffold properties in relation to biological functions, structural demands, material composition, and both conventional and advanced manufacturing methods. Additionally, current limitations and future outlooks are discussed. Moreover, the paper highlights that the continued development of bio-scaffolds could open new avenues in tissue engineering, leading to more advanced biomimetic bone substitutes with strong potential for clinical translation.</p>