<p>Obesity, as a growing public health problem worldwide, is closely related to the development of various chronic diseases, including kidney damage. Obesity not only affects an individual’s metabolic capacity but also leads to notable changes in kidney structure and function. Recent studies have found that serum miRNAs are important in obesity and its related complications, making them potential biomarkers and treatment targets. Serum miRNAs might affect kidney function by regulating processes such as cell proliferation, apoptosis, inflammation, and fibrosis. However, there are still some gaps in current research, such as the specific ways miRNAs work and how they relate to obesity-related kidney damage not being fully understood. This review looks at how obesity impacts kidney function by changing serum miRNAs, analyzes the relevant mechanisms, and summarizes current research progress to offer insights for future research and clinical treatments.</p>