Diabetic wounds represent a significant challenge in the medical field, significantly impacting patient quality of life and imposing a heavy burden on healthcare systems. Intelligent hydrogel dressings have attracted significant attention in diabetic wound treatment due to their unique properties. This review systematically explores the three main categories of intelligent hydrogels (natural, synthetic, and composite), dissecting their composition, structure, and the mechanisms that enable their intelligent responses. The crucial roles of these dressings in maintaining a moist wound environment, efficiently absorbing exudate, and precisely delivering drugs are expounded. Moreover, their application advantages in combating bacteria and infections, regulating inflammation and immunity, promoting angiogenesis and tissue regeneration, as well as enabling real-time monitoring and personalized treatment, are explored in depth. Additionally, we discuss future research directions and the prospects for personalized precision medicine in diabetic wound care, aiming to inspire innovation and provide a comprehensive theoretical basis for the development of next-generation intelligent dressings.