The aim of this research was to explore the complexity of college student food insecurity through eating patterns, food assistance, and health of food-insecure university students. A mixed-methods approach utilizing qualitative focus groups and individual interview data and survey quantitative data was used. All data collection took place on campus at a large Midwestern university in the Spring semester of 2018. Participants were Midwestern university students (n = 30), freshman to graduate level classified, with very low food security (USDA-Six Item Short Form). Seven percent (n = 2) were currently enrolled in food assistance programming (SNAP), and 30% (n = 9) reported family enrollment growing up (WIC and SNAP). Seven major themes emerged highlighting nutritional habits, food adaptations, health and well-being impacts, and additional campus programming addressing food assistance. Data triangulation informed a complexity diagram with the major categories of student characteristics of food insecurity, campus resource barriers, additional student needs, health and well-being impacts, and student adaptations and coping influencing the complexity surrounding student food insecurity. College student food insecurity is multifaceted and complex. Common themes emerged among both individual-level factors and university structures, providing a deeper understanding of both the complexity and contributors to the college student experience. Further research and intervention are needed to explore this phenomenon and address student needs.