Abstract: Diabetic wounds exhibit poor healing due to a hyperglycemic microenvironment, susceptibility to infection, and vascular neuropathy. Traditional treatments such as debridement, dressing changes, and antimicrobial therapy yield limited efficacy and fail to meet clinical demands. Although hydrogel dressings possess excellent biocompatibility and water absorption, making them ideal dressing substrates, they lack sufficient antimicrobial capacity and tissue regeneration capabilities, rendering them inadequate for the complex therapeutic needs of diabetic wounds. Given the positive regulatory role of endogenous electric fields in wound repair, nanocomposite conductive hydrogels—created by integrating conductive nanomaterials with hydrogel matrices—exhibit promising applications in diabetic wound care by imparting electrical activity, antimicrobial properties, anti-inflammatory effects, and smart responsiveness. This review summarizes extensively studied nanocomposite conductive hydrogels based on differences in conductive components. It delves into intrinsic factors such as synthesis methods and structural composition, as well as the regulation of electrical properties by external stimuli (force/light/magnetism/heat). The review comprehensively summarizes the mechanisms and efficacy of these materials in diabetic wound repair. Finally, it analyzes key bottlenecks in clinical translation, personalized treatment, and large-scale production within this field, while outlining future development prospects. This aims to provide reference and insights for the development of clinical diabetic wound dressings.