FLORENCE, S.C. — Hillary Clinton’s commanding lead in this Southern state doesn’t include young voters, who have consistently rejected the front-runner for the Democratic nomination and prevented her from rebuilding the coalition that carried Barack Obama to the White House in 2008.

Mrs. Clinton has assembled other fragments of the Obama coalition: black voters, Hispanic voters and women. But voters younger than 45 mostly remain skeptical of the former secretary of state and have moved in droves to support Sen. Bernard Sanders, a self-proclaimed democratic socialist from Vermont.

Mrs. Clinton sustained a strong lead in South Carolina, topping Mr. Sanders by more than 20 points in most polls as the state prepared to hold its first-in-the-South primary Saturday.

Nevertheless, Democrats worry that young voters will stay on the sidelines if Mrs. Clinton wins the nomination, jeopardizing the party’s chances for keeping the White House.

Teresa Myers Ervin, a member of the Florence City Council and a Clinton supporter, said her candidate must rebuild the Obama coalition to win the general election and urged her to do more to connect with young voters.

“The campaign needs to seek more youth leaders to be involved,” she said while attending a Clinton rally at the Cumberland United Methodist Church. “She has to get the support of people who backed Obama. That’s going to push her over the top.”

Ken McWilliams, 63, a retired chemical operator, said Mrs. Clinton was beginning to aggressively court younger voters. He noted that Mrs. Clinton at the church stressed her commitment to reducing student debt and making college more affordable, issues that resonate with young voters.

“These young people have to be motivated,” he said. “She didn’t realize she was going to have to work as hard as she is. Bernie came out of nowhere. I think everybody recognizes that.”

“I’m shocked by what I hear from students,” Mrs. Clinton said at the church, describing a South Carolina college graduate who is paying a 13 percent interest rate on her federal student loans.

She said student debt was “weighing young people down” and vowed that if elected president she would prohibit the federal government from profiting from the loans.

“Imagine a tomorrow where education is once again a passport to opportunity,” Mrs. Clinton said.

Still, Mr. Sanders has generated intense enthusiasm among young voters, and that could make it difficult for them to realign behind Mrs. Clinton if she becomes the party’s nominee.

What’s more, young voters — especially college-age voters — don’t have long histories of supporting the Clintons and often judge the candidate harshly.

“I don’t like Hillary. I think she’s a liar,” said Carlo Mutuc, 20, a mechanical engineering student at South Carolina University who voted early for Mr. Sanders.

He was among students who said they didn’t know whether they could support Mrs. Clinton in a general election.

Fellow engineering student Jared O’Quinn, who also voted early for Mr. Sanders, said he would back Mrs. Clinton in a general election matchup only if Donald Trump was the Republican nominee. He said he would be voting against Mr. Trump, not for Mrs. Clinton.

“She doesn’t have the best interests of America at heart,” said Mr. O’Quinn.

In South Carolina, Mrs. Clinton’s advantage comes from overwhelming support of black voters, who make up about half of the state’s Democratic electorate.

Her weakness is glaringly apparent among white voters younger than 45. That group dramatically tilts to Mr. Sanders 67 percent to 22 percent, according to a recent Bloomberg Politics poll.

However, young voters were not enough to make Mr. Sanders competitive in the Democratic primary.

Cognizant of his long odds in South Carolina, Mr. Sanders barely campaigned in the state this week. He instead focused on the multistate contests that begin with Super Tuesday next week, when he will need to score victories to keep his campaign viable.

Mrs. Clinton’s young voter deficit has been evident in the first three nominating contests that preceded South Carolina.

In the Iowa caucuses, where Mrs. Clinton barely edged out Mr. Sanders, voters younger than 30 broke for Mr. Sanders 84 percent to 14 percent, according to entrance polls.

When Mr. Sanders handily defeated Mrs. Clinton in the New Hampshire primary, exit polls showed him winning voters younger than 30 by 83 percent to 16 percent and voters ages 30 to 40 by 66 percent to 32 percent.

Mrs. Clinton rebounded to win the Nevada caucuses but lost voters younger than 45 to Mr. Sanders 72 percent to 31 percent.

In each of these contests, Mrs. Clinton won support from older voters by equally large margins.

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