Engineered living materials (ELMs), as the intersection of materials science and synthetic biology, aim to recapitulate desirable properties of natural living biomaterials to create programmable functions that can sense and respond to the biological environment. ELMs are designed to confer/enhance material properties by introducing endogenous or exogenous functional biomaterial modules. Thus, ELMs sense external stimuli, spontaneously perform biologically programmed functions, and produce multiple functional outputs. These properties may significantly overcome limitations of traditional synthetic materials in terms of available stimuli and chemically driven responses, thus achieving a wide range of applications in biomedical applications such as drug delivery, chemotherapies, biomedical devices, biosensor design, and other related fields. Additionally, ELMs may be applied to regulate cell dynamic behavior by reprogramming cell-cell or cell-environment interactions to prepare biomaterials with dynamic response characteristics. Therefore, in this chapter, we first introduce the research history of ELMs, stimulus-responsive ELMs, and the necessary design of the ELMs to construct the electrochemical biosensing interface. Then, we focus on the recent advances in design strategies for ELMs from the perspective of electrochemical biosensing and diagnostic applications. Finally, we discuss the positive impact of ELMs on promoting the development of multidisciplinary fields and critical future research directions.