Metal-based nanowires (MNWs) are unique nanomaterials with high aspect ratio, adaptability, and conductivity, making them promising for electrical biosensing. This review discusses their role in sensor technologies, focusing on their assembly methods, advantages in biosensing, and integration with machine learning and digital health. MNWs are used to fabricate electrochemical and field-effect transistor (FET) biosensors, offering enhanced sensitivity, improved signal-to-noise ratios, and increased surface area for efficient biomolecule immobilization. Electrochemical biosensors are cost-effective, easy to use, and compatible with compact instruments, while FET biosensors offer potential for early biomarker detection and pharmaceutical applications. MNWs also contribute to biosensing platforms with high precision and reliability, especially in complex environments. Their unique surface topology enhances interactions with biomolecules, crucial for biosensing. MNWs are also promising for FET biosensors due to their high aspect ratio, tunable surface chemistry, and excellent electrical conductivity. Researchers are exploring novel synthesis methods and surface functionalization techniques to tailor MNWs for specific biomolecular interactions. The integration of MNWs into FET biosensors has shown advancements in detecting various biomolecules. The review also discusses two primary methodologies for constructing MNW networks: bottom-up and top-down approaches. MNW sensors have shown progress in various applications, but challenges remain, including enhancing sensitivity and selectivity, ensuring long-term stability, adapting to real-world conditions, and developing low-power consumption sensors. Ethical and environmental considerations are also important, as the production of MNW sensors may involve energy-intensive processes and chemicals. Proper disposal of nanomaterials is essential to prevent environmental contamination. This review highlights future trends and challenges in the use of MNWs for biosensors.Metal-based nanowires (MNWs) are unique nanomaterials with high aspect ratio, adaptability, and conductivity, making them promising for electrical biosensing. This review discusses their role in sensor technologies, focusing on their assembly methods, advantages in biosensing, and integration with machine learning and digital health. MNWs are used to fabricate electrochemical and field-effect transistor (FET) biosensors, offering enhanced sensitivity, improved signal-to-noise ratios, and increased surface area for efficient biomolecule immobilization. Electrochemical biosensors are cost-effective, easy to use, and compatible with compact instruments, while FET biosensors offer potential for early biomarker detection and pharmaceutical applications. MNWs also contribute to biosensing platforms with high precision and reliability, especially in complex environments. Their unique surface topology enhances interactions with biomolecules, crucial for biosensing. MNWs are also promising for FET biosensors due to their high aspect ratio, tunable surface chemistry, and excellent electrical conductivity. Researchers are exploring novel synthesis methods and surface functionalization techniques to tailor MNWs for specific biomolecular interactions. The integration of MNWs into FET biosensors has shown advancements in detecting various biomolecules. The review also discusses two primary methodologies for constructing MNW networks: bottom-up and top-down approaches. MNW sensors have shown progress in various applications, but challenges remain, including enhancing sensitivity and selectivity, ensuring long-term stability, adapting to real-world conditions, and developing low-power consumption sensors. Ethical and environmental considerations are also important, as the production of MNW sensors may involve energy-intensive processes and chemicals. Proper disposal of nanomaterials is essential to prevent environmental contamination. This review highlights future trends and challenges in the use of MNWs for biosensors.