Student-centered teaching techniques and equitable assessments are crucial in high-quality education. Asking students to write multiple-choice questions (MCQs) over course content and including them on exams may address both concurrently. Much of the work surveying students' responses to this practice involved graduate level education in specialized programs (e.g., medical or pharmacology school) and generated inconsistent or conflicting findings. Furthermore, minimal research has investigated whether students within majority and minority identity groups perceive this practice similarly. To explore undergraduate students' perceptions of student-created MCQ exams, this study analyzed open-ended and closed-ended survey responses from 40 students who wrote MCQs in an undergraduate human physiology course. Closed-ended responses were positive, indicating increased engagement, assessment satisfaction, and self-efficacy. The survey results indicated that there were no differences in perception between minority and majority groups. Open-ended responses were also largely positive, reflecting improved metacognition, content knowledge, and socioemotional state. Concerns included question wording resulting in difficulty variations and perceptions that the practice is best applied to questions requiring basic knowledge or recall. Student-created MCQ exams were largely well-received and appear to be an engaging student learning activity. Future studies should focus on improving student question writing techniques and expand into larger populations and more diverse content.