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Background: Patient and public involvement (PPI) is increasingly recognised as essential for meaningful, equitable, and impactful health and social care research. Co-creation is a promising involvement approach, but it faces barriers to enable its optimal potential. Digital technologies have the potential to overcome these challenges and strengthen the participatory process, but the specific technology needs that underpin effective participation and engagement remain underexplored.

Methods: We conducted a comprehensive scoping review of 60 peer-reviewed studies to systematically map the digital technology needs supporting co-creation processes. Needs were extracted and thematically analysed, resulting in a structured synthesis.

Results: A total of 337 distinct digital technology needs were identified and organised into five thematic areas: Ensuring Integrity, Enabling Methodology, Cognitive Needs, Group Dynamics, and Process Management. While most needs focused on functional attributes, non-functional characteristics, such as usability, scalability, and inclusivity, emerged as critical for meaningful patient and public engagement. The review highlights the fragmented articulation of technology needs across disciplines and settings. It proposes a structured framework to make latent needs visible, align stakeholder perspectives, and guide the development of digital tools. The emerging role of artificial intelligence in supporting hybrid models of involvement, along with the associated ethical challenges, is also discussed.

Conclusion: This review provides the first thematic framework for understanding and addressing digital technology needs in co-creation. The findings offer a foundation for researchers, practitioners, and policy-makers within health and social care to develop and implement digital tools that enhance accessibility, engagement, and impact of participatory processes. Future research should validate and refine these insights in partnership with patients, service users, and diverse communities to ensure technological solutions foster truly inclusive and effective involvement.