Industry 4.0 is expected to change competitiveness of manufacturing firms. However, to completely achieve this goal, firms should manage barriers and complexity issues that my hinder its adoption or its effects. For this reason, the study explores, through a literature review, whether and how design theory may be a supporting theory to manage Industry 4.0 adoption and implementation to maximise the opportunities and minimise the risks. The results shows that these research questions require a design approach to innovate not only adopting technologies but reinventing the business practices.