The long strip of peninsula is natural but it would constantly change shape as sand is eroded and piles up in other parts. Every few decades you have to replace the bulkheads which hold a wall between the land and water at the back of the deck.
There are lots of sandbars in the bay, I've been in my boxers at 5am many times trying to push my boat and a group of friends off a sandbar on our way home.
In the summer there would be thousands of boats and you could sit there watching a whole line of idiots go full throttle towards the middle of a sandbar and people would go flying when they beach it.
Originally indians lived there in the marshy parts and assawoman bay area.
Ocean city is also the white marlin capital of the world. Our neighbor won the tournament 10+ years ago and won a couple million bucks.
White Marlin Open