This study assesses the evolution of 104 inhabited and 82 resort islands across the Maldives between 2004-2006 and 2014-2016 and investigates the contribution of human drivers. Using multi-date satellite imagery, we show that 59.1% of these islands expanded as a result of human intervention, including mainly land reclamation (often associated with harbor development) and the construction of engineering structures. Land reclamation drove island expansion on 93.5% of inhabited islands, whereas land reclamation and/or the effects of engineered structures (especially groins and breakwaters) were involved in 79.2% of the resort islands. Almost 52% of the islands that increased in size experienced growth rates ≥10%, with 13 inhabited and 6 resort islands exhibiting growth rates ≥50%. As a result of widespread human intervention, these islands behave very differently from both the documented Pacific islands and the Maldivian islands of Gaafu-Alifu Dhaalu Atoll (most of which are ‘natural’), 15.5% and 19.5% of which underwent expansion over the past decades, respectively. Changes on the islands were driven by political-institutional (one-size-fits-all risk reduction policy based on hard engineering in inhabited islands), demographic (population growth) and socioeconomic (developing and securing outer inhabited islands and post-tsunami tourism growth) factors. The Maldivian island model of ‘reclamation-fortification’ has detrimental impacts on the environment while also questioning the future capacity of the Maldives to face a hard path under increasing risks. Results from the Maldives more broadly offer lessons for other island countries and territories by highlighting the importance of distinguishing between inhabited and exploited and natural islands, and accounting for path dependencies, when designing adaptation solutions.