The main purpose of this article is to explore the mechanism of action of carbon-based materials in the anaerobic digestion (AD) production of medium-chain carboxylic acids (MCCA). Currently, there are various methods to increase production, but there is no review on how carbon-based materials improve MCCA. This paper first introduced the chain elongation (CE) technology, focusing on the factors affecting the production of MCCA by AD, such as pH, temperature, the ratio of electron donor (ED) to an electron acceptor (EA), substrate type, and other related factors. This article introduces the preparation and characteristics of carbon-based materials, as well as the effect and mechanism of adding carbon-based materials to AD acid production. Finally, the shortcomings of the current research were pointed out, and future research directions were prospected, aiming to provide a reference for improving the efficiency of AD of MCCA using carbon-based materials.