Surface-enhanced Raman scattering (SERS) has emerged as an excellent analytical tool for the effective detection and fingerprint identification of various chemicals. Recently, significant progress has been made in the fabrication of SERS-active substrates using simple, inexpensive, and affordable methods. The full potential of universal SERS diagnostics will likely be realized with the development of approaches and devices capable of effectively detecting analytes on various surfaces as well as in multicomponent media. In addition, the combination of implantable or wearable SERS-active substrates and remote portable devices enables real-time diagnostics that ideally fit the concept of personalized medicine. In this paper, we summarize recent achievements in fabricating flexible SERS substrates made of cellulose paper, polymer membranes, and textile fibrous films. Emphasis is placed on the in-situ extraction and detection of various chemicals in real-world surfaces and complex media using flexible nanofibrous SERS platforms. The potential SERS applications and future perspectives in on-site diagnostics are also discussed.