The rapid development of precise diagnosis and treatment of diabetes has imposed higher requirements for the sensitivity, selectivity, and stability of glucose sensors. Given the bottlenecks of traditional carbon nanotubes in electrochemical sensing applications, such as low purity, numerous structural defects, and poor biocompatibility, this paper systematically reviews the mechanism of glucose detection, preparation and purification of high-purity carbon nanotubes, and the preparation methods and advantages of carbon nanotube-metal nanoparticle composite electrodes. To address these critical limitations, this review focuses on three interconnected aspects of CNT-based glucose sensing technology. First, the catalyst regeneration, dynamic process control and green carbon source substitution have effectively overcome the problems of high energy consumption, low purity and environmental burden of traditional methods. Second, the purification and innovative functionalization of carbon nanotubes have significantly improved their purity and electrochemical performance. Finally, the preparation method of a carbon nanotube-metal nanoparticle composite electrode is described. It not only achieves the precise spatial positioning of the catalytic active center, but also significantly enhances the long-term stability of the electrode through the synergistic regulation of chemical bonding strength and interface electronic structure. These advancements lay a theoretical foundation for the development of a new generation of wearable sensors with antibiofouling properties and resistance to complex physiological interferences.