Securing the Internet of Medical Things ( IoMT ): A Comprehensive Taxonomy, Quantitative Benchmark, and Future Roadmap of Authentication Protocols

The Internet of Medical Things (IoMT) is transforming modern healthcare by enabling continuous patient monitoring and remote diagnostic services through interconnected medical devices. However, the heterogeneous and resource‐constrained characteristics of IoMT environments introduce security and privacy challenges, including repudiation, data tampering, and unauthorized access, thereby making a robust authentication mechanism a fundamental requirement. These vulnerabilities emphasize the necessity of advanced and privacy‐preserving authentication techniques capable of ensuring secure access control and user anonymity in IoMT systems. In this context, this paper presents a systematic literature review that provides a comprehensive survey of authentication mechanisms in IoMT environments. Authentication schemes are analysed and compared based on their underlying techniques, security properties, resistance to cyberattacks, and challenges specific to IoMT systems. Furthermore, this review explores the validation of authentication schemes using security simulation tools, incorporating both formal and informal verification methods to assess their correctness. Moreover, this review identifies and discusses key authentication challenges in IoMT environments, examines solution strategies, and evaluates the performance of authentication schemes in terms of computational overhead. Finally, emerging research directions and future implications are outlined to guide the development of secure authentication schemes. This review aims to serve as a valuable reference for beginners and experts working in the field of IoMT security, especially those who focus on understanding authentication mechanisms and related security challenges.