Inspired by the remarkable surface wetting behavior of natural organisms, artificially designed superwettable systems have attracted significant attention from multidisciplinary scientists over the past two decades. Starch is an eco-friendly, nontoxic, and low-cost natural polymer that serves as an alternative to nonbiodegradable and/or bioincompatible synthetic polymers in these systems. This review explores the unique contributions of starch to superwettable systems from design principles to emerging applications. First, the fundamental theories and design principles underlying starch-involved superwettable systems are introduced. The specific design principles of these systems are comprehensively discussed from the aspects of intrinsic properties (e.g., hydrophilicity, film-forming properties, adhesiveness, and thermal decomposition), dimensionality (e.g., colloidal systems, zero-dimensional granules/particles, one-dimensional fibers, two-dimensional films/fibrous membranes/coatings, and three-dimensional fillers/porous materials/food textures), and biotransformation. It also provides an overview of their applications in functional biomaterials, oral delivery systems, emulsion polymerization, packaging technology, food taste modulation, and water treatment, with particular emphasis on intelligent systems. Each section summarizes recent advancements, highlighting the chemical and structural features. Finally, the review considers prospects for these superwettable systems, focusing on underutilized starch attributes and technical challenges.