Applications related to alkali-activated materials (AAMs) have received much attention due to their excellent mechanical properties and low-energy production. Although much research has focused on developing AAMs, their application is still limited. One of the primary reasons is the efflorescence. Not only does efflorescence affect the material aesthetics, but it also affects the mechanical performance, leading to a decrease in material quality. This paper first summarizes the current research on AAMs efflorescence. The formation process of efflorescence is divided into three parts: alkaline cation leaching, air carbonation, and efflorescence formation. Furthermore, the influences caused by different factors, including raw materials, curing conditions, AAMs modalities, etc., on the efflorescence are proposed. This paper highlights the solutions for efflorescence by avoiding free alkaline cation leaching and preventing air carbonation. The advantages and disadvantages of efflorescence are discussed in-depth, showing that it can be exploited under certain conditions, such as in wastewater treatment. This paper has important implications for the practical preparation and application of AAMs.