<p>Osteoarthritis (OA) is a widespread joint disorder that has emerged as a significant global healthcare challenge. Over the past decade, advancements in material science and medicine have transformed the development of functional materials aimed at addressing the complex issues associated with the diagnosis and treatment of OA. This review synthesizes the latest advancements in various types of intelligent micro-structured materials and their design principles. By examining the exceptional structural characteristics of materials with unique properties such as tailored attributes, controllability, biocompatibility, and bioactivity, we emphasize the design of composite materials for precise and early intervention in OA. This is achieved through advanced imaging techniques and machine learning-based analysis, alongside the customization of micro-structured material properties to align with the biological and mechanical requirements of specific joint tissues. This review offers an in-depth analysis of the transformative potential of advanced technologies and artificial intelligence (AI) in the development of innovative solutions for OA diagnosis and therapy. It aims to inform future research and inspire the creation of next-generation smart materials with unprecedented performance, thereby enhancing our capabilities in the prevention and treatment of OA.</p>