The COVID-19 pandemic disrupted routine healthcare services, including testing and treatment for sexually transmitted infections (STIs). At the same time, it fostered optimism about the potential of direct-to-consumer (DTC) self-testing solutions, fueled by remarkable progress in self-sampling practices, rapid testing technologies, and the adaptation of regulatory frameworks. Direct-to-consumer (DTC) self-testing and self-sampling for STIs became then still a more critical alternative, offering privacy, accessibility, and the potential to address testing gaps, especially for underserved, at-risk groups. This review critically analyzed the literature published since the onset of the COVID-19 pandemic. DTC testing has evolved significantly since the pandemic, with notable advances in technology, availability, and disease and geographical coverage. It has increased STI testing uptake among underserved or hesitant populations, including men who have sex with men and young adults. However, issues around cost, data reporting, and follow-up care persist, and many at-risk groups still lack access. While these solutions have improved testing uptake and public health outcomes, anticipated widespread adoption and advances have been slower than expected. Limited market options, weak research, and regulatory challenges have hindered growth. Research has often focused on potential user acceptance rather than real-world usage. Future directions should leverage trendy approaches in medical ethnography and transformational marketing to emphasize user- and data-driven innovation, affordability, and regulatory support based on private provider accountability.