Novel AI-Driven Precision Strategies in Diabetic Wound Healing: Immunomodulation and Advances in Smart Composite Nanocarriers

Diabetic chronic wounds (CWs) represent a recalcitrant, difficult-to-heal pathological condition characterized by an imbalance of the immune microenvironment. Smart composite nanocarriers for immune regulation enable multi-targeted, spatiotemporally controllable synergistic interventions by responding to pathological signals such as reactive oxygen species (ROS), pH, and abnormal enzyme activity, thereby offering a novel pharmaceutical strategy to overcome the limitations of traditional single-target therapies. Artificial intelligence (AI) integrates clinical and biological data to predict healing risks, optimize treatment plans and nanocarrier design, and dynamically adjust strategies based on patient conditions, ensuring precision and personalized therapies. This paper systematically reviews the immunopathological basis of CWs, summarizes the design rationale and functional evolution of immune-modulating smart composite nanocarriers, and discusses an AI-enabled precision therapy framework from an interdisciplinary perspective. It aims to establish a theoretical foundation and research paradigm for constructing programmable drug delivery systems tailored to complex disease microenvironments, facilitating the transition of smart nanopharmacy from material-oriented to system-regulation-oriented approaches, and accelerating the clinically predictable translation of diabetic wound therapies.