The pathogenesis of inflammatory diseases involves complex cellular cascades within tissues, where macrophages play a pivotal role. These cells exhibit remarkable phenotypic plasticity and can polarize into M1 or M2 types depending on the stage of inflammation to adapt to the microenvironment. Environmental adaptability changes prompt macrophages to undergo metabolic reprogramming, providing necessary energy support for cells to effectively participate in anti-inflammatory responses and regulate inflammatory processes. However, research on metabolic reprogramming in anti-inflammatory therapy remains insufficient. This review systematically described the mechanism of macrophages in inflammation process and the latest research progress on metabolic reprogramming. It pointed out the challenges faced by metabolic reprogramming in treating inflammatory diseases and suggests that future research on macrophage metabolic reprogramming should focus on the following areas: 1) exploring the mechanism by which metabolic reprogramming products affect the production of inflammatory cytokines by macrophages; 2) conducting an in-depth analysis of the molecular mechanism of metabolic reprogramming in regulating macrophages; 3) exploring the effects of individual differences on the regulation of macrophage metabolic pathways and customizing individualized treatment plans based on these differences.