Chronic and diabetic wounds represent a major clinical challenge, necessitating innovative therapeutic strategies. Smart hydrogels have emerged as a transformative class of wound dressings capable of dynamically responding to environmental stimuli—such as light, temperature, pH, glucose, and reactive oxygen species (ROS)—thereby enabling accelerated healing and enhanced wound management. This review systematically evaluates the diverse categories of smart hydrogel dressings and their demonstrated efficacy in experimental studies. Key findings highlight that light-responsive hydrogels, incorporating photothermal and photodynamic nanoparticles, exhibit robust antibacterial activity and spatiotemporally controlled drug release. Thermo-sensitive hydrogels, such as poly(N-isopropylacrylamide), promote wound contraction and closure via temperature-dependent structural changes. pH-responsive systems integrate real-time diagnostic capabilities with on-demand therapeutic release through colorimetric indicators and pH-triggered mechanisms. Notably, glucose-responsive hydrogels have achieved 91.4% faster diabetic wound healing by modulating insulin release and glycemic control. ROS-scavenging hydrogels mitigate oxidative stress while fostering tissue regeneration through free radical neutralization. Furthermore, breakthroughs in self-healing hydrogels and sensor-integrated smart systems facilitate real-time wound monitoring and adaptive responses to physiological movements. The incorporation of artificial intelligence further refines precision wound management. Collectively, smart hydrogels represent a paradigm shift in the treatment of complex wounds, offering multifunctional, stimuli-responsive solutions with significant translational potential.