Recently, organic electrochemical transistors (OECTs) have emerged as robust platforms for chemical and biological sensing, due to their intrinsic signal amplification, biocompatibility, and low-voltage functionality. OECTs have exhibited tremendous promise for detecting small molecule metabolites (SMMs), which are crucial as biomarkers in medical diagnosis, environmental surveillance, and food quality monitoring. This review provides an in-depth analysis of recent advancements in OECT-based sensing devices for the detection of SMMs. Besides, the fundamental design concepts of OECTs, device structures, choice of materials, and functionalization techniques are studied to enhance selectivity and sensitivity. The incorporation of recognition elements-such as enzymes, aptamers, and molecularly imprinted polymers-on the gate or channel to facilitate target-specific interactions has been studied. Furthermore, the significance of channel engineering, microfluidic integration, and nanomaterial inclusion in improving device performance has also been discussed. The review highlights the main obstacles that impede the extensive development of OECTs, including baseline drift, signal instability, and selectivity. Finally, future prospects are explored, emphasizing rising trends in smart materials, micro platforms, and wearable diagnosis. This study seeks to assist researchers in creating next-generation OECT sensors designed for real-time, selective, and sensitive identification of SMMs.
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