Molecular imprinting technology (MIT) is a method for creating molecular locks that complement specific molecular bonds. This technology yields molecularly imprinted polymers (MIPs), which feature specific binding sites that emulate interactions observed in enzyme-substrate or antigen–antibody binding. The distinctive recognition specificity, structural predictability, and high stability of MIPs have positioned them as key areas of interest within drug delivery systems (DDS). Here, we comprehensively review the recent advancements in composite materials integrating MIPs for DDS (MIPs-DDS). Firstly, we provide a brief introduction to MIPs based on the types of forces acting between templates and functional monomers, then classify and introduce MIPs-DDS based on the types of doped nanomaterials, including metal–organic frameworks (MOFs), quantum dots (QDs), carbon nanotubes (CNTs), siloxane, up-conversion nanoparticles (UCNPs), metallic nanoclusters and magnetic nanoparticles (MNPs). We then delve into the delivery modes and release mechanisms of MIPs-DDS, encompassing factors such as pH, light response, temperature, magnetic response, glutathione, and multi-responsive mechanisms. Additionally, we emphasized the application of MIPs-DDS in cancer, diabetes, eye diseases and other diseases, as well as in the selection and delivery of stereoisomeric drugs. Finally, we outline the existing challenges and future perspectives for MIPs-DDS, aiming to accelerate the development of MIT and facilitate the creation of innovative multifunctional DDS for diverse applications.