Natural gas hydrate reservoirs in the northern South China Sea primarily comprise clayey silt, making exploitation more challenging relative to sandy reservoirs in other countries and regions. This paper provides an overview of the latest research developments in the exploitation mechanism covering the past five years, focusing on hydrate phase transition, multiphase flow in the decomposition zone, the seepage regulation of reservoir stimulation zone, and production capacity simulation, all of which are relevant to the previously conducted two rounds of hydrate trial production in offshore areas of China. The results indicate that the phase transition of clayey-silt hydrate remains in a dynamic equilibrium, with the decomposition efficiency mainly controlled by the coupling of heat and flow and high heat consumption during decomposition. The decomposition zone exhibits strong hydrophilicity, easy adsorption, and sudden permeability changes. A temperature drop is present that is concentrated near the wellbore, and once a water lock has formed, the gas-phase flow capacity significantly decreases, leading to potential secondary hydrate formation. To enhance permeability and increase production, it is imperative to implement reservoir and temperature field reconstruction based on initial formation alterations, which will further optimize and improve the transport capacity of the reservoir.