Malaysia's extensive coastline supports globally significant blue carbon ecosystems, including mangrove forests, seagrass meadows, tidal wetlands, and coral reefs that provide essential ecosystem services such as carbon sequestration, biodiversity conservation, fisheries production, and coastal protection. Despite increasing investments in ecosystem restoration, many initiatives remain centred on restoring ecosystems rather than strengthening the relationships between people and nature that underpin their long-term resilience. This review synthesises evidence from Indigenous and local communities across Peninsular Malaysia, Sabah, and Sarawak to examine how Indigenous cosmologies, customary law (Adat), Traditional Ecological Knowledge (TEK), and community stewardship can strengthen ecosystem restoration and Nature-based Solutions (NbS). The Malaysian case studies demonstrate that spiritual relationships with nature, customary governance, place-based ecological knowledge, and emerging collaborative approaches contribute to more resilient coastal social-ecological systems and provide practical pathways for strengthening blue carbon initiatives, community-led conservation, Other Effective Area-Based Conservation Measures (OECMs), and ecosystem restoration under the UN Decade on Ecosystem Restoration and the Kunming–Montreal Global Biodiversity Framework. The evidence highlights that successful restoration depends not only on rebuilding habitats but also on strengthening the social, cultural, institutional, and knowledge systems that sustain long-term stewardship of coastal ecosystems. By integrating Indigenous knowledge with scientific innovation, participatory governance, and interdisciplinary collaboration, Malaysia offers a practical model for advancing more equitable, adaptive, and durable Nature-based Solutions that simultaneously support biodiversity conservation, climate mitigation, sustainable livelihoods, and community well-being.