Exosomes are a kind of nanoscale membrane vesicles that can be secreted by many types of cells in both normal and pathological states and play a very important role in intercellular information exchange and transmission by transporting proteins, nucleic acids, lipids, and other biologically active substances to act on the receptor cells. Recent studies have shown that exosomes from some plants, animals, microorganisms, and other food sources can also be extracted like the structure of exosomes secreted by mammalian cells, which are named food-derived exosomes (FDEs) and can be absorbed by intestinal cells and further transported to other organs through blood circulation. With the advantages of high biocompatibility, low immunogenicity, low toxicity, high cargo capacity, and the ability to cross biological barriers, FDEs can be involved in a variety of applications such as immune response, cell migration, and tumor invasion, and have attracted a lot of attention as biotherapeutic agents and drug delivery carriers in the treatment of human diseases. This article reviews the classification, preparation characterization, physiological processes in the human body, biological functions, and application prospects of FDEs. It aims to provide a reference for the research and application of FDEs in disease treatment.