Plastics are widely used across various industries due to their flexibility, cost-effectiveness, and durability. This extensive use has resulted in significant plastic pollution, with microplastics (MPs) becoming pervasive contaminants in water bodies worldwide, adversely affecting aquatic ecosystems and human health. This review explores the surface characteristics of carbon-based adsorbents, including biochar, activated carbon, carbon nanotubes (CNTs), and graphene, and their influence on MP removal efficiency. Key surface characteristics such as the carbon content, surface area, pore size, and particle size of adsorbents influenced adsorption efficiency. Additionally, hydrophobic interaction, van der Waals forces, π–π interactions and electrostatic interaction were found to be mechanisms by which microplastics are trapped onto adsorbents. Modified biochar and activated carbon demonstrated high adsorption efficiencies, while CNTs and graphene, with their high carbon contents and well-defined mesopores, showed outstanding performance in MP removal. Although a high surface area was generally associated with better adsorption performance, modifications significantly enhanced efficiency regardless of the initial surface area. This review emphasizes the importance of understanding the relationship between surface characteristics and adsorption efficiency to develop optimized adsorbents for MP removal from wastewater. However, challenges such as the lack of standardized testing methods, variability in biochar performance, and the high cost of regenerating carbon adsorbents remain. Future research should focus on developing cost-effective production methods, optimizing biochar production, and exploring advanced modifications to broaden the application of carbon adsorbents. Integrating advanced adsorbents into existing water treatment systems could further enhance MP removal efficiency. Addressing these challenges can improve the effectiveness and scalability of carbon-based adsorbents, significantly contributing to the mitigation of microplastic pollution in wastewater.