<p>Metformin has recently garnered attention for its unique role in cellular metabolism regulation, prompting investigations into its potential applications in skin wound healing. Predictive, preventive, and personalized medicine (PPPM/3PM) is the most advantageous healthcare framework and is appropriate for managing chronic illnesses. This review systematically outlines the key signaling pathways through which metformin modulates inflammatory responses via metabolic reprogramming. Integrating the 3PM concept, it explores innovative application strategies for metformin in wound management, thereby proposing a working hypothesis: metformin may be utilized for personalized prevention and treatment of skin wounds. It focuses on the latest research advances in the field of wound healing, particularly the potential of metformin in local applications, as well as studies combining it with innovative carriers such as hydrogels, nanofibers, and microneedles. These studies not only expand the therapeutic scope of metformin but also provide novel perspectives and solutions to the management of chronic wounds.</p>