The article reviews the polarization of macrophages and their functions in various inflammatory diseases. Macrophages exhibit diversity and plasticity, with M1 macrophages (classically activated) being pro-inflammatory and M2 macrophages (alternatively activated) associated with anti-inflammatory reactions and tissue remodeling. The transformation of macrophage phenotypes regulates the initiation, development, and cessation of inflammatory diseases. The article discusses the roles of macrophage polarization in infection, atherosclerosis, obesity, tumor, asthma, and sepsis. It highlights the importance of targeting macrophage polarization to adapt their phenotype to the microenvironment for treating inflammatory diseases. Key transcription factors such as STATs, IRFs, NF-κB, AP1, PPARγ, and CREB are involved in macrophage polarization, and their interactions regulate macrophage phenotypes in different inflammatory conditions. The article also addresses challenges in macrophage polarization research, including the need for further studies on cellular markers, the differences between mouse and human macrophages, and the importance of understanding the microenvironment's role in macrophage polarization.The article reviews the polarization of macrophages and their functions in various inflammatory diseases. Macrophages exhibit diversity and plasticity, with M1 macrophages (classically activated) being pro-inflammatory and M2 macrophages (alternatively activated) associated with anti-inflammatory reactions and tissue remodeling. The transformation of macrophage phenotypes regulates the initiation, development, and cessation of inflammatory diseases. The article discusses the roles of macrophage polarization in infection, atherosclerosis, obesity, tumor, asthma, and sepsis. It highlights the importance of targeting macrophage polarization to adapt their phenotype to the microenvironment for treating inflammatory diseases. Key transcription factors such as STATs, IRFs, NF-κB, AP1, PPARγ, and CREB are involved in macrophage polarization, and their interactions regulate macrophage phenotypes in different inflammatory conditions. The article also addresses challenges in macrophage polarization research, including the need for further studies on cellular markers, the differences between mouse and human macrophages, and the importance of understanding the microenvironment's role in macrophage polarization.