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Wearable smart devices have become ubiquitous in modern society, extensively researched for their health monitoring capabilities and convenience features. However, the “wearability” of these devices remains a relatively understudied area, particularly in terms of design informed by clinical trials. Wearable devices possess significant potential to enhance daily life, yet their success depends on understanding and validating the design factors that influence comfort, usability, and seamless integration into everyday routines. This review aimed to evaluate the “wearability” of smart devices through a mixed-methods scoping literature review. By analyzing studies on comfort, usability, and daily integration, it sought to identify design improvements and research gaps to enhance user experience and system design. From an initial pool of 130 publications (1998–2024), 19 studies met the inclusion criteria. The review identified three significant outcomes: (1) a lack of standardized assessment methods, (2) the predominance of qualitative over quantitative assessments, and (3) limited utility of findings for informing design. Although qualitative studies provide valuable insights, the absence of quantitative research hampers the development of validated, generalizable design criteria. This underscores the urgent need for future studies to adopt robust quantitative methodologies to better assess wearability and inform evidence-based design strategies.