Despite proven effectiveness and accuracy in laboratories, the existing damage assessment based on guided ultrasonic waves (GUWs) or acoustic emission (AE) confronts challenges when extended to real-world structural health monitoring (SHM) for railway tracks. Central to the concerns are the extremely complex signal appearance due to highly dispersive and multimodal wave features, restriction on transducer installations, and severe contaminations of ambient noise. It remains a critical yet unsolved problem along with recent attempts to implement SHM in bourgeoning high-speed railway (HSR). By leveraging authors' continued endeavours, an SHM framework, based on actively generated diffuse ultrasonic waves (DUWs) and a benchmark-free condition contrast algorithm, has been developed and deployed via an all-in-one SHM system. Miniaturized lead zirconate titanate (PZT) wafers are utilized to generate and acquire DUWs in long-range railway tracks. Fatigue cracks in the tracks show unique contact behaviours under different conditions of external loads and further disturb DUW propagation. By contrast DUW propagation traits, fatigue cracks in railway tracks can be characterised quantitatively and the holistic health status of the tracks can be evaluated in a real-time manner. Compared with GUW- or AE-based methods, the DUW-driven inspection philosophy exhibits immunity to ambient noise and measurement uncertainty, less dependence on baseline signals, use of significantly reduced number of transducers, and high robustness in atrocious engineering conditions. Conformance tests are performed on HSR tracks, in which the evolution of fatigue damage is monitored continuously and quantitatively, demonstrating effectiveness, adaptability, reliability and robustness of DUW-driven SHM towards HSR applications.