Abstract: Exosomes are vesicular structures secreted by a variety of cells, with a size of approximately 40-160 nm. The engineering of exosomes is currently a hot topic in drug delivery research. Engineering methods include changing the loading mode to alter the contents and targeting functionality of exosomes, and combining the advantages of exosomes with tissue engineering materials. This article reviews the methods of constructing engineered exosomes, the application of exosomes combined with tissue engineering materials, and the influencing factors of exosomes' distribution in vivo to elucidate the current research progress of engineered exosomes in drug delivery, aiming to provide some reference for the subsequent clinical application of exosomes.