Long-term investigations have revealed incidences of severe flange wheel wear in the field. Slight changes in the profile shape will lead to changes in the geometric relationship between wheel and rail, hence affecting the dynamic wheel-rail interaction. The turnout is an essential piece of track equipment for carrying out train transfer or cross line operation. In turnouts, the rail profile changes throughout the structure, and the wheel load transfers from one rail component to the next, resulting in a complex wheel/rail relationship. This paper investigates the effect of flange wear on the wheel-rail interaction as the vehicle switches into the turnout track in a diverging movement. A coupling model for a high-speed flexible turnout and a multi-rigid vehicle is established, and the dynamic contact trajectories between wheel and rail, the vibration energy of the rail, the lateral wheel-rail force, rail wear, and car body driving stability are analyzed. The results show that the wheel transition position is shifted backward due to the flange wear, and a less sharp impact occurs with a worn flange profile during wheel load transition in the switch panel, which improves lateral wheel-turnout interaction and the rail wear. Worn flange profiles give a large flangeway clearance, which is not conducive to the smooth operation of vehicles in the diverging route of turnouts.