Nanozyme Biosensors for Clinical and Wearable Diagnostics: Multimodal Signal Transduction, Diagnostic Confidence, and Translational Barriers

Nanozyme-based biosensors are emerging as artificial enzyme platforms for clinically significant and wearable diagnostic systems because they combine catalytic signal generation with structural robustness, tunable surface chemistry, and compatibility with miniaturized devices. This review specifically focuses on clinically oriented and wearable nanozyme biosensors. In this context, it addresses topics such as material design, biointerface engineering, signal transduction, multimodal validation, device integration, and validation-not as independent performances but as an interconnected chain aimed at a single application. The primary contribution of this review is its emphasis on diagnostic reliability. This review also examines the major barriers limiting translation to clinical practice, including deficiencies in catalytic specificity, matrix interference, biological contamination, real-sample variability, interbatch inconsistency, scalable production, biosafety, and regulatory readiness. In the study, multimodal, smartphone-based, and AI-assisted reading results were evaluated based on whether they enhance quantitative reliability, reduce interpretation uncertainty, and support clinically meaningful decisions. A goal-oriented framework for transforming nanozyme biosensors from promising laboratory prototypes into clinically reliable, wearable, and digitally connected diagnostic technologies has been identified in the study.