Smart nanomaterials have emerged as a pivotal innovation in tissue engineering, offering enhanced structural and functional properties for regenerative medicine. This chapter explores the role of these advanced materials in scaffolds, bioprinting, and stem cell integration, emphasizing their impact on exosome-based therapies. Smart nanomaterials facilitate controlled exosome delivery, improving stability, targeting, and therapeutic efficacy in skin regeneration, cartilage repair, and bone healing. The discussion covers nanomaterial-enhanced scaffolds, bio-inks, and bioprinting technologies that enable precise tissue modeling. Additionally, a systematic review of in vitro, in vivo, and clinical studies highlights recent advancements and challenges in translating nanomaterial-based exosome therapies to clinical applications. The chapter concludes with future perspectives on nanomaterial functionalization, personalized regenerative strategies, and regulatory considerations, underscoring the transformative potential of smart nanomaterials in next-generation tissue engineering. Key findings from this chapter highlight that nanomaterial-integrated scaffolds reinforce mechanical strength and bioactivity and guide stem cell differentiation, accelerating tissue repair and regeneration. Moreover, the incorporation of nanoparticles into bioinks enables high-precision bioprinting, fostering the development of biomimetic architectures tailored for personalized regenerative medicine. Despite these advancements, challenges related to large-scale production, regulatory compliance, and long-term biocompatibility persist. Addressing these limitations through interdisciplinary collaboration and technological refinement will be essential to harnessing the full potential of smart nanomaterials in next-generation regenerative medicine.