The Caribbean region remains susceptible to an increasing frequency of natural disasters, rising international debt, out-migration, rapid urbanization, and high imports to meet basic needs. Food and nutrition insecurity persists in these small island states, with around 67.5% of the population living in moderate or severe food insecurity. Policy adjustments required to address the targets subsumed by the second sustainable development goal (SDG2 or Zero Hunger) are still at an infant stage. This research offers rigorous and up-to-date analyzes of the current status of Caribbean food policies and practices through a scoping review and expert interviews to answer the question, “What constraints and enablers impact the ability of small island states to achieve the Zero Hunger goal?”. A scoping review is performed following the relevant population, concept, and context (PCC) methodology by the Joanna Briggs Institute (JBI). Five major challenges and barriers are identified through the scoping review: (i) island geography, (ii) governance deficiencies, and (iii) institutional constraints, compounded by (iv) collaboration barriers, and (v) externally imposed impediments (including environmental and financial shocks). To address these challenges, synergistic linkages and restrictive connections have been recognized for SDG2 localization. It was concluded that three dimensions of food security (utilization, agency, and sustainability) are mainly overlooked, necessitating special attention and action. By identifying bridging institutions and engaging various actors in supporting shared rulemaking, power, conflict management, and knowledge-sharing among local, national, and regional policy actors, a polycentric governance system is recommended as a suitable mechanism to help islands move towards food security.