Objective The advantages, mechanisms, and advances in nanocomposites for delivering bioactive substances in bone tissue engineering were systematically reviewed. MethodsThis review provides a comprehensive analysis by conducting an in-depth retrieval of relevant literature and integrating it with related work from our research team. ResultsCapitalizing on their inherent size effects and tunable structures, nanocomposites exhibit high drug-loading capacity and controlled/targeted delivery, allowing for the co-delivery of diverse molecules. This smart delivery capability, responsive to specific pathological or external cues, facilitates on-demand precision release to execute multiple therapeutic functions, including osteogenesis, antibacterial action, and immunomodulation. ConclusionNanocomposites demonstrate high delivery efficiency and controlled release kinetics, with the potential for future clinical translation of their multi-signal responsive and spatiotemporally precise drug release capabilities.