Foundation models for medical image segmentation have achieved remarkable performance. Adaptive fine-tuning of natural image segmentation foundation models is crucial for medical image segmentation tasks. However, some limitations exist in existing fine-tuning methods: 1) insufficient representation of high-level features and 2) the fine-tuning process disrupts the structural integrity of pretrained weights. Inspired by these critical problems, we propose an intelligent communication mixture-of-experts boosted-medical image segmentation foundation model, named IC-MoE, with twofold ideas: 1) We construct basic experts, semantic experts, and adaptive experts. Moreover, we implement a pixel probability adaptive voting strategy, which enables expert selection and fusion through label consistency and load balancing. This approach preliminarily enhances the representation capability of high-level features while preserving the structural integrity of pretrained weights. 2) We propose a semantic-guided contrastive learning method to address the issue of weak supervision in contrastive learning. This method further enhances the representation capability of high-level features while preserving the structural integrity of pretrained weights. Extensive experiments across three public medical image segmentation datasets demonstrate that the IC-MoE outperforms other SOTA models. Consequently, the proposed IC-MoE effectively supplements foundational medical image segmentation models with high-level features and pretrained structural integrity. We also validate the superior generalizability of the IC-MoE across diverse medical image segmentation scenarios.