Food-derived extracellular vesicles (FEVs) are nanoscale membrane vesicles obtained from dietary materials such as breast milk, plants, and probiotics. Unlike other extracellular vesicles, FEVs can survive the harsh conditions of the gastrointestinal tract and reach the intestines, making them promising prebiotics and oral nanomedicine for gut disorders. Recent studies suggest that FEVs may also have therapeutic effects in non-gastrointestinal diseases, though the mechanisms are not fully understood. It is proposed that FEVs primarily act locally in the intestine by modulating the intestinal microenvironment, such as barrier integrity and microbiota, thereby exerting therapeutic effects on the liver via the gut-liver axis. FEVs may also deliver drugs to the gastrointestinal system, which can act via the gut-liver axis. The liver, as the main metabolic hub, is involved in various metabolic diseases, and gut disorders are associated with conditions like non-alcoholic fatty liver disease, obesity, diabetes, and cardiovascular disease. FEVs have shown therapeutic potential in gut disorders and metabolic diseases, with their mechanisms of action involving the gut-liver axis. FEVs are derived from various food sources, including milk, plants, and probiotics, and are characterized by their size, surface charge, and bioactive components. FEVs are resistant to the harsh gastrointestinal environment and can be administered orally. Studies show that FEVs can reach the colon and other organs, but the extent of their distribution to remote organs like the liver is limited. FEVs have been shown to modulate gut microbiota, improve gut barrier integrity, and exert therapeutic effects on liver diseases. They also have potential in treating other metabolic diseases such as obesity, type 2 diabetes, and cardiovascular disease through the gut-liver axis. The therapeutic potential of FEVs is supported by their ability to modulate gut microbiota, enhance gut barrier function, and influence liver metabolism. FEVs are a promising approach for the treatment of gut and liver diseases, as well as other metabolic disorders, through the gut-liver axis.Food-derived extracellular vesicles (FEVs) are nanoscale membrane vesicles obtained from dietary materials such as breast milk, plants, and probiotics. Unlike other extracellular vesicles, FEVs can survive the harsh conditions of the gastrointestinal tract and reach the intestines, making them promising prebiotics and oral nanomedicine for gut disorders. Recent studies suggest that FEVs may also have therapeutic effects in non-gastrointestinal diseases, though the mechanisms are not fully understood. It is proposed that FEVs primarily act locally in the intestine by modulating the intestinal microenvironment, such as barrier integrity and microbiota, thereby exerting therapeutic effects on the liver via the gut-liver axis. FEVs may also deliver drugs to the gastrointestinal system, which can act via the gut-liver axis. The liver, as the main metabolic hub, is involved in various metabolic diseases, and gut disorders are associated with conditions like non-alcoholic fatty liver disease, obesity, diabetes, and cardiovascular disease. FEVs have shown therapeutic potential in gut disorders and metabolic diseases, with their mechanisms of action involving the gut-liver axis. FEVs are derived from various food sources, including milk, plants, and probiotics, and are characterized by their size, surface charge, and bioactive components. FEVs are resistant to the harsh gastrointestinal environment and can be administered orally. Studies show that FEVs can reach the colon and other organs, but the extent of their distribution to remote organs like the liver is limited. FEVs have been shown to modulate gut microbiota, improve gut barrier integrity, and exert therapeutic effects on liver diseases. They also have potential in treating other metabolic diseases such as obesity, type 2 diabetes, and cardiovascular disease through the gut-liver axis. The therapeutic potential of FEVs is supported by their ability to modulate gut microbiota, enhance gut barrier function, and influence liver metabolism. FEVs are a promising approach for the treatment of gut and liver diseases, as well as other metabolic disorders, through the gut-liver axis.