Indigenous Mexican fermented beverages, such as pulque, colonche, tepache, and water kefir, are pillars of the country’s cultural and gastronomic heritage. Their sensory attributes and health-promoting properties arise from complex microbial consortia, in which lactic acid bacteria (LAB), mainly Lactobacillus and Leuconostoc, acetic acid bacteria (AAB), primarily Acetobacter, and yeasts such as Saccharomyces and Candida interact and secrete exopolysaccharides (EPSs). Dextran, levan, and heteropolysaccharides rich in glucose, galactose, and rhamnose have been consistently isolated from these beverages. EPSs produced by LAB enhance the viscosity and mouthfeel, extend the shelf life, and exhibit prebiotic, antioxidant, and immunomodulatory activities that support gut and immune health. Beyond food, certain EPSs promote plant growth, function as biocontrol agents against phytopathogens, and facilitate biofilm-based bioremediation, underscoring their biotechnological potential. This review integrates recent advances in the composition, biosynthetic pathways, and functional properties of microbial EPSs from Mexican fermented beverages. We compare reported titers, outline key enzymes, including dextransucrase, levansucrase, and glycosyltransferases, and examine how fermentation variables (the substrate, pH, and temperature) influence the polymer yield and structure. Finally, we highlight emerging applications that position these naturally occurring biopolymers as sustainable ingredients for food and agricultural innovation.