Place pineapple, mango, banana, coconut milk, orange juice, Greek yogurt, and honey in a blender. Add a handful of ice if not using frozen fruit.
Blend until smooth and creamy.
Adjust the consistency of the smoothie by adding more or less liquid. If it's too thick, add a bit more orange juice or coconut milk. If it's too thin, add more frozen fruit, yogurt, or ice.
Taste and adjust sweetness if needed by adding more honey.
Pour into a tall glass, garnish with a slice of pineapple or a wedge of mango if desired.