The process of coal measure gas accumulation is relatively complex, involving multiple physicochemical processes such as migration, adsorption, desorption, and seepage of multiphase fluids (e.g., methane and water) in coal measure strata. This process is constrained by multiple factors, including geological structure, reservoir physical properties, fluid pressure, and temperature. This study used Well Z-7 in the Qinshui Basin as the research object as well as numerical simulations to reveal the processes of methane generation, migration, accumulation, and dissipation in the geological history. The results indicate that the gas content of the reservoir was basically zero in the early stage (before 25 Ma), and the gas content peaks all appeared after the peak of hydrocarbon generation (after 208 Ma). During the peak gas generation stage, the gas content increased sharply in the early stages. In the later stage, because of the pressurization of the hydrocarbon generation, the caprock broke through and was lost, and the gas content decreased in a zigzag manner. The reservoirs in the middle and upper parts of the coal measure were easily charged, which was consistent with the upward trend of diffusion and dissipation and had a certain relationship with the cumulative breakout and seepage dissipation. The gas contents of coal, shale, and tight sandstone reservoirs were positively correlated with the mature hydrocarbon generation of organic matter in coal seams, with the differences between different reservoirs gradually narrowing over time.