As technologies such as artificial intelligence, autonomous driving, the Internet of Things, wearable electronics, and edge computing continue to spread in the era of the Fourth Industrial Revolution, the importance of hardware security for the safe storage, transmission, and processing of large volumes of data has grown substantially. One of the key components of such security systems is the true random number generator (TRNG), which produces unpredictable random numbers for cryptographic use. In recent years, research on TRNGs has increasingly moved beyond conventional CMOS-based approaches toward semiconductor devices built from emerging materials. These material-based TRNGs offer several advantages, including high integration density, low power consumption, compact form factors, and strong suitability for next-generation edge and IoT environments, because they can directly exploit the intrinsic stochasticity of the device itself as an entropy source. In this review, recent studies on TRNGs based on emerging material-based semiconductor devices are examined from the perspectives of entropy sources, device structures, randomness validation, and wearable/flexible extensions. By bringing together the key physical mechanisms, device platforms, evaluation criteria, and prospects for wearable and flexible electronics in edge and IoT environments, this review aims to provide a useful framework for future research on hardware security devices.