Abstract: In the implementation of the Healthy China strategy, the integration of sports and health has emerged as a vital approach to address the gap between the supply and demand of health services and to enhance public health outcomes. Through a combination of case studies, field research, and interviews, this study provides a systematic analysis of the local implementation models of sports-health integration under the Healthy China initiative. It identifies predominant challenges and proposes innovative pathways for enhancement. The study concludes that, depending on the type of leading service provider, local sports-health integration practices in China have developed into several distinct models: hospital-led models, focused on disease prevention, treatment, and rehabilitation; community-led models, which integrates national fitness with public health; research institution-led models driving industry-academia-research synergy; enterprise-led models, integrating sports and health industries; and government-led models, steering development through policy and resource allocation. However, current local practices in sports-health integration continue to face common challenges, including the absence of collaborative innovation mechanisms, a systemic treatment-over-prevention bias, and a shortage of specialized professionals. Additionally, each stakeholder encounters specific obstacles: the hospital system grapples with standardizing and ensuring the precision of exercise prescriptions; grassroots community services struggle with organizational and resource constraints; research institutions face barriers in commercializing their innovations; market entities confront issues with market access and data sharing; and government agencies are challenged by inadequate resource allocation and a lack of robust outcome evaluation mechanisms. To address these issues, we propose optimization strategies for sports-health integration from both a holistic perspective—such as fostering a collaborative innovation ecosystem, promoting proactive health awareness, and improving talent development mechanisms—and a stakeholder-specific angle, including standardizing implementation of exercise prescriptions, enhancing community resource provision mechanism, stimulating the commercialization of scientific and technological innovations, refining market access standards, and optimizing governmental performance evaluation frameworks.