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While traditional hydrogels aid tissue repair, their functionality is often compromised at low temperatures. Herein, we report a polyphenol\u2010mediated conductive hydrogel that remains stable and functional at \u201080\u00b0C. Engineered from casein, dopamine\u2010modified poly(3,4\u2010ethylenedioxythiophene), and a synergistic antifreeze system (dopamine, gluten, glycerol), the hydrogel maintains its conductivity, bioactivity, and therapeutic efficacy after freezing. The hydrogel functions both as a therapeutic dressing and a bioelectronic interface. When coupled with vagus nerve stimulation (VNS), the hydrogel synergistically accelerates full\u2010thickness wound healing by regulating inflammation, scavenging ROS, promoting macrophage M2 polarization, and enhancing angiogenesis. Its remarkable cryo\u2010stability is attributed to polyphenol\u2010mediated water confinement and cryoprotective gluten micelles. Concurrently, the hydrogel facilitates real\u2010time ECG, EMG, and EEG monitoring and enables VNS\u2010driven modulation of EEG\u2010\u03b1 waves to alleviate depressive\u2010like behavior. This integrated system presents a novel therapeutic paradigm for managing both the physiological and psychological complications of diabetes, even under extreme environmental conditions.<\/jats:p>","DOI":"10.1002\/smll.202512099","type":"journal-article","created":{"date-parts":[[2026,1,31]],"date-time":"2026-01-31T12:07:26Z","timestamp":1769861246000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Extreme\u2010Environment Adaptive Hydrogel with Vagus Nerve Modulation for Diabetic Wound Healing and Emotion Management"],"prefix":"10.1002","volume":"22","author":[{"given":"Yue","family":"Hou","sequence":"first","affiliation":[{"name":"Institute of Biomedical Engineering, College of Medicine Southwest Jiaotong University  Chengdu Sichuan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaochuan","family":"Guo","sequence":"additional","affiliation":[{"name":"The Third People's Hospital of 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