Nanozymes, characterized by enzyme-like activity, have been extensively used in quantitative analysis and rapid detection due to their small size, batch fabrication, and ease of modification. Researchers have combined aptamers, an emerging molecular probe, with nanozymes for biosensing to address the limited reaction specificity of nanozymes. Nanozyme aptasensors are currently experiencing significant growth, offering a promising solution to the lack of rapid detection methods across various fields. Unlike traditional nanozyme research, the development of nanozyme aptasensors is challenging as it requires the design of highly active nanozymes as well as the establishment of efficient and agile interactions between aptamers and nanozymes. Therefore, this review summarizes the active species and catalytic mechanisms of various nanozymes along with classical design options, discussing the future development of nanozyme aptasensors. It is anticipated that this review will inspire researchers in this domain, leading to the design of more enzymatically active nanozymes and advanced nanozyme aptasensors.