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Figure 1. Both natural and engineered EVs offer significant promise in the treatment of bone aging. MEVs, BEVs, and PEVs can efficiently regulate bone metabolism, thus offering a promising therapeutic approach for related diseases. Based on existing research, we propose a novel therapeutic strategy utilizing OEVs. Created in BioRender. Bigbone B. (2025) https://BioRender.com/ldwwnlx.00. EVs: Extracellular vesicles; MEVs: mammalian extracellular vesicles; PEVs: plant-derived extracellular vesicles; BEVs: bacterial extracellular vesicles; OEVs: organoid-derived extracellular vesicles.