This review highlights the emerging role of metal-based nanowires (MNWs) in electrical biosensing, emphasizing their unique properties such as adaptability, high aspect ratio, and conductivity. The authors provide an in-depth examination of MNW assembly methods, detailing procedural aspects, foundational principles, and performance metrics. MNWs are shown to enhance the sensitivity, signal-to-noise ratios, and surface area for efficient biomolecule immobilization in electrochemical and field-effect transistor (FET) biosensors. These advancements optimize the performance of biosensing platforms for various applications, including diagnostics and environmental monitoring. The review also explores the integration of machine learning and digital health with MNWs in electrical biosensing, outlining future trends and challenges. Key challenges include improving sensitivity and selectivity, ensuring long-term stability, adapting to real-world conditions, and developing low-power consumption sensors. Ethical and environmental considerations are also discussed, emphasizing the need for sustainable practices in the production and disposal of MNW sensors.This review highlights the emerging role of metal-based nanowires (MNWs) in electrical biosensing, emphasizing their unique properties such as adaptability, high aspect ratio, and conductivity. The authors provide an in-depth examination of MNW assembly methods, detailing procedural aspects, foundational principles, and performance metrics. MNWs are shown to enhance the sensitivity, signal-to-noise ratios, and surface area for efficient biomolecule immobilization in electrochemical and field-effect transistor (FET) biosensors. These advancements optimize the performance of biosensing platforms for various applications, including diagnostics and environmental monitoring. The review also explores the integration of machine learning and digital health with MNWs in electrical biosensing, outlining future trends and challenges. Key challenges include improving sensitivity and selectivity, ensuring long-term stability, adapting to real-world conditions, and developing low-power consumption sensors. Ethical and environmental considerations are also discussed, emphasizing the need for sustainable practices in the production and disposal of MNW sensors.