Metal–organic frameworks (MOFs) have a good designability, a well-defined pore, stimulus responsiveness, a high surface area, and a controllable morphology. Up to now, various MOFs have been widely used as nanocarriers and have attracted lots of attention in the field of drug delivery and release because of their good biocompatibility and high-drug-loading capacity. Herein, we provide a comprehensive summary of MOF-based nanocarriers for drug delivery and release over the last five years. Meanwhile, some representative examples are highlighted in detail according to four categories, including the University of Oslo MOFs, Fe-MOFs, cyclodextrin MOFs, and other MOFs. Moreover, the opportunities and challenges of MOF-based smart delivery vehicles are discussed. We hope that this review will be helpful for researchers to understand the recent developments and challenges of MOF-based drug-delivery systems.