Disruptions in lipid metabolism cause numerous metabolic diseases, including obesity, diabetes, cardiovascular diseases, and liver disorders. Consequently, lipid metabolism serves as a potential therapeutic target, influencing the progression of various non-metabolic diseases such as kidney diseases, cancer, neurodegenerative disorders, aging, and bone-related diseases. The metabolic pathways involved in lipid metabolism are complex and highly interconnected. Although the abundance of metabolic targets presents opportunities for lipid metabolism regulation, the limited precision and safety of traditional therapeutic approaches remain significant challenges. These limitations have catalyzed the development of multifunctional nano-delivery platforms aimed at targeted intervention in lipid metabolic processes, further enhancing the flexibility of lipid metabolism regulation. This review outlines the latest advancements and representative applications of these multifunctional nano-delivery platforms. Notably, extensive research has been conducted on nanoparticles and liposomes, with these technologies being relatively mature. Furthermore, numerous novel biomaterials, including engineered adipocytes, exosome vesicles secreted by natural cells, smart-responsive nanomicelles, composite hydrogels, and engineered lipid droplets, are being increasingly explored. Finally, the review discusses the advantages of drug delivery strategies based on the targeted intervention of lipid metabolic processes, the limitations of current technologies, promising future research directions, and treatment challenges.