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Stimulus\u2010responsive nanoplatforms, which function as \u201cbiomarker\u2010triggered\u201d therapeutic systems, have emerged as a frontier in precision sepsis management. These platforms are engineered to autonomously sense pathological hallmarks within the sepsis microenvironment\u2014such as fluctuations in pH, reactive oxygen species (ROS), and specific enzymatic over\u2010expression\u2014thereby enabling precise, spatiotemporal drug release. Unlike conventional static therapies, these \u201csmart\u201d nanoplatforms modulate therapeutic intervention in real\u2010time based on disease progression. This review comprehensively evaluates the integration of sensing and therapy using nanoplatforms loaded with antibiotics, antimicrobial peptides, anti\u2010inflammatory agents, and gene\u2010regulatory molecules. We highlight how these platforms optimize therapeutic windows by enhancing local drug bioavailability while minimizing systemic off\u2010target toxicity. Furthermore, we discuss the current hurdles in clinical translation, including patient\u2010specific biomarker variability and the complexity of scalable fabrication. Finally, we propose future directions, emphasizing the synergy of real\u2010time biosensing, artificial intelligence (AI), and multimodal \u201ctheranostic\u201d platforms to achieve stage\u2010specific, personalized interventions. 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