The global energy transition urgently requires the development of safe, economical, and high-performance energy storage technologies. Aqueous Zinc-Ion Batteries (AZIBs) have emerged as potential candidates for large-scale energy storage due to their inherent safety, environmental friendliness, and abundant resources. Manganese-based cathode materials have become a key component of AZIBs because of their high theoretical capacity (~308 mAh g-1 ), relatively high operating voltage, and naturally abundant resources. However, in practical applications, they are still restricted by inherent defects such as low electronic conductivity, manganese dissolution, and capacity fading caused by structural instability. This paper systematically reviews the structural configuration and energy storage mechanism of AZIBs and deeply analyzes the fundamental challenges faced by manganese-based cathodes. We particularly emphasize four breakthrough modification strategies: lattice support regulation, defect state engineering, nanostructure design, and composite material construction. Focusing on discussing breakthrough solutions such as composite hybridization, defect regulation, and innovative structural engineering to address specific issues like particle agglomeration, uneven particle size, and Mn3+ disproportionation dissolution. Finally, this paper comprehensively evaluates the synergistic effects and inherent limitations among various modification methods. We propose that future research should focus on stable interface engineering, new dissolution inhibition mechanisms, and scalable manufacturing processes, thus laying the theoretical foundation for advancing high performance AZIB systems.