<p>As ideal hard tissue prostheses, titanium alloys offer excellent biocompatibility and mechanical properties, but the inherent bioinertness may hinder osseointegration. To address this issue, biomimetic apatite coatings have been developed to improve osteoconductivity and biological integration. This review summarizes recent advances in such coatings, with a focus on microstructure, adhesion strength, and biological performance. These coatings are primarily composed of hydroxyapatite (HA), along with minor phases of β-tricalcium phosphate and octacalcium phosphate. The deposition process can be enhanced by using a supersaturated calcium phosphate solution and pre-calcification treatment, while adhesion can be strengthened through silanization or immersion in citric acid-modified simulated body fluid. Furthermore, functionalized HA coatings demonstrate pronounced antibacterial efficacy, reactive oxygen species scavenging capability, and osteoinductive properties. Current challenges and future directions are also discussed to facilitate clinical translation. These include mechanical evaluations (e.g., under complex stress conditions) and long-term in vivo implantation studies. Moreover, elucidating the interactions and synergistic mechanisms in multi-dopant HA systems (e.g., Ag⁺, norvancomycin, polydopamine, bone morphogenetic protein) is crucial to assess their efficacy in conferring multiple properties. Future research should employ advanced machine learning technique to optimize the microstructure and performance of biomimetic apatite coatings on titanium alloys.</p>