Metal-organic frameworks (MOFs) are promising nanozyme materials with unique properties such as high catalytic activity, stability, and tunability. This review discusses recent advances in MOF-based nanozymes (MOF-NZs) and their applications in biomedicine. MOFs mimic enzyme-like activities through their structural components, including metal nodes and organic ligands, which can act as redox couples and mediators. MOF-NZs have been developed for biosensing, therapeutics, and other biomedical applications. Different types of MOF-NZs, including peroxidase-, oxidase-, superoxide dismutase (SOD)-, and catalase-mimic nanozymes, have been explored for their catalytic activities. Modified MOFs, such as those with heteroatom doping or metal oxide nanoparticles, have shown enhanced catalytic performance. Challenges in MOF-NZs include limited catalytic active sites, poor substrate specificity, and the need for precise control over catalytic mechanisms. Strategies to enhance MOF-NZ activity include structural modification, porosity tuning, dimension control, and functionalization. These approaches aim to improve the catalytic performance and biomedical applications of MOF-NZs. The review highlights the potential of MOF-NZs as alternatives to natural enzymes in biomedical applications.Metal-organic frameworks (MOFs) are promising nanozyme materials with unique properties such as high catalytic activity, stability, and tunability. This review discusses recent advances in MOF-based nanozymes (MOF-NZs) and their applications in biomedicine. MOFs mimic enzyme-like activities through their structural components, including metal nodes and organic ligands, which can act as redox couples and mediators. MOF-NZs have been developed for biosensing, therapeutics, and other biomedical applications. Different types of MOF-NZs, including peroxidase-, oxidase-, superoxide dismutase (SOD)-, and catalase-mimic nanozymes, have been explored for their catalytic activities. Modified MOFs, such as those with heteroatom doping or metal oxide nanoparticles, have shown enhanced catalytic performance. Challenges in MOF-NZs include limited catalytic active sites, poor substrate specificity, and the need for precise control over catalytic mechanisms. Strategies to enhance MOF-NZ activity include structural modification, porosity tuning, dimension control, and functionalization. These approaches aim to improve the catalytic performance and biomedical applications of MOF-NZs. The review highlights the potential of MOF-NZs as alternatives to natural enzymes in biomedical applications.