Several issues (and I'll tell you right now that your question is not fully answerable because of one of the issues).

The first issue we can fix easily. The [square] brackets form a character class. So your regex is matching any single character that has a letter I, N, S, E, R, T, C, R, E, A, T, E, in it, or a | character. That's not what you want. You probably intended to constrain an alternation while capturing whichever choice matched. So m/^[INSERT|CREATE] should be m/(INSERT|CREATE).

The next issue is this construct: (.*).+ Perl has no idea (and neither do I, which is what part of what makes this question unanswerable) where the dot-star capture is supposed to end, and the dot-plus match is supposed to begin. Actually, Perl has a rule that will govern what happens here, but it doesn't match what you intend, and Perl doesn't realize or care. The dot-star is going to capture as much as it possibly can, and then it will give one character back so that the dot-plus can match right before a semicolon. The dot-plus will match the space character right before the semicolon, and nothing more. Is this what you wanted? If so, just use a single unquantified dot.

Third: if you want . (dot) to match across multiple lines the /s modifier will be needed.

Also, if you intend for line 24 of your input to initiate a new match, then the ^ will need to take on the meaning where it gets to match after a newline rather than only at the start of the string. That means you'll need the /m modifier.

my( $start, $query ) = $line =~ m/^(INSERT|CREATE)(.+);/msig;
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This is probably still broken, since the dot-plus is greedy, and will probably just devour both the first and the second query all at once.

So while I've provided the regex above, I feel it really doesn't get you much closer to a workable and robust solution. Your question was seeking regex support, but I feel that's focusing too much on the tool you've chosen to use rather than on what actually needs to be accomplished. It's probably a better choice to turn to a module such as SQL::Statement to handle your SQL parsing for you in a more robust and predictable way.

And even that is not going to get you 100% of the way there, because the queries are embedded in another markup (probably XML), so another parser for that layer will be advisable.