St. Louis Cardinals catcher Yadier Molina was among the announced replacements, but he opted later Saturday to decline so he can rest his foot rather than making his 10th appearance in Tuesday's game at Coors Field in Denver.
Molina was to replace Buster Posey's spot on the National League roster, but that will instead go to Milwaukee Brewers catcher Omar Narvaez. Philadelphia Phillies catcher J.T. Realmuto, who finished second on the player ballot, is starting in Posey's place.
With the addition of Narvaez, there are a record 40 first-time All-Stars.
Atlanta Braves star Ronald Acuna Jr., elected to start in the All-Star Game as the NL's top vote-getter among outfielders, tore the ACL in his right knee on Saturday during Atlanta's 5-4 win over the Miami Marlins and will miss the rest of the season. He was replaced on the All-Star roster by San Diego Padres third baseman Manny Machado.
American League replacements for the All-Star Game are shortstop Tim Anderson (Chicago White Sox), starting pitcher Chris Bassitt (Oakland Athletics), second baseman Whit Merrifield (Kansas City Royals) and shortstop Joey Wendle (Tampa Bay Rays).
In the National League, the new All-Stars are Narvaez, pitchers Walker Buehler (Dodgers), Freddy Peralta (Brewers), Max Scherzer (Washington Nationals) and Taijuan Walker (New York Mets) and third baseman Justin Turner (Dodgers).
The players who will be inactive in the All-Star Game include two pitchers scheduled to start for their respective clubs on Sunday -- Kevin Gausman (San Francisco Giants) and Brandon Woodruff (Brewers); seven players who are out with an injury -- Betts, Brantley, Jose Altuve (Astros), Carlos Correa (Astros), Jacob deGrom (Mets), Yu Darvish (San Diego Padres) and Buster Posey (Giants); and one player out on paternity leave -- Ryan Pressly (Astros).
Betts said Saturday that an accumulation of "nagging'' injuries led to his decision to pass on the All-Star Game. He still started in right field on Saturday for the Dodgers, and he is expected to be available for their game on Sunday.
The appointments of Anderson and Merrifield in the AL come via the player ballot to replace the player-elected Correa and Altuve, respectively.
Buehler, Merrifield and Turner will each appear on an All-Star roster for the second time, and Anderson, Bassitt, Peralta, Narvaez, Walker and Wendle each earn their first selections -- making it a record 40 first-time All-Stars.
It also marks the third consecutive All-Star Game with at least 30 players making their debut on an All-Star roster. At least 30 players have now been first-time All-Stars in seven of the past eight games and nine of the past 11 installments.
With the additions of Molina, Narvaez and Peralta, there are now 25 internationally born players on the All-Star rosters (15 AL, 10 NL), including players from the Dominican Republic (8), Venezuela (6), Japan (3), Cuba (2), Puerto Rico (2), Aruba (1), Australia (1), Canada (1) and Curaçao (1).
The American League leads the series 45-43, with two ties.
The Associated Press contributed to this report.