Nanotechnology and machine learning: a promising confluence for the advancement of precision medicine

The fusion of molecular-scale engineering in nanotechnology with machine learning (ML) analytics is reshaping the field of precision medicine. Nanoparticles enable ultrasensitive diagnostics, targeted drug and gene delivery, and high-resolution imaging, whereas ML models mine vast multimodal datasets to optimize nanoparticle design, enhance predictive accuracy, and personalize treatment in real-time. Recent breakthroughs include ML-guided formulations of lipid, polymeric, and inorganic carriers that cross biological barriers; AI-enhanced nanosensors that flag early disease from breath, sweat, or blood; and nanotheranostic agents that simultaneously track and treat tumors. Comparative insights into Retrieval-Augmented Generation and supervised learning pipelines reveal distinct advantages for nanodevice engineering across diverse data environments. An expanded focus on explainable AI tools, such as SHAP, LIME, Grad-CAM, and Integrated Gradients, highlights their role in enhancing transparency, trust, and interpretability in nano-enabled clinical decisions. A structured narrative review method was applied, and key ML model performances were synthesized to strengthen analytical clarity. Emerging biodegradable nanomaterials, autonomous micro-nanorobots, and hybrid lab-on-chip systems promise faster point-of-care decisions but raise pressing questions about data integrity, interpretability, scalability, regulation, ethics, and equitable access. Addressing these hurdles will require robust data standards, privacy safeguards, interdisciplinary R&D networks, and flexible approval pathways to translate bench advances into bedside benefits for patients. This review synthesizes the current landscape, critical challenges, and future directions at the intersection of nanotechnology and ML in precision medicine. • Integration of nanotechnology and machine learning enhances the precision of personalized medicine. • Applications include early disease detection, personalized drug delivery, advanced imaging, and real-time monitoring. • Machine learning aids in optimizing nanocarrier design and predictive diagnostics. • Nanotechnology enables targeted therapy and high-resolution disease visualization. • Ethical, technical, and regulatory challenges remain, but future innovations offer promising solutions.