Carotenoids, as natural components with potential antioxidant activity, offer extensive benefits for maintaining human health, including vision protection, skin health maintenance, immune enhancement, and prevention of chronic diseases. Adequate intake of carotenoids, particularly the macular pigments lutein and zeaxanthin, through diet or supplements is essential to promote health. This review first systematically summarizes the dietary sources of carotenoids, as well as the types, content, and bioactivity of carotenoids in maize. It then analyzes the impact of processing and storage methods on their content. Building on this foundation, this article focuses on the germination process, highlighting the biosynthetic pathways of carotenoids in maize and the methods for their enrichment in maize sprouts. Special emphasis is placed on the induction and regulation of key enzyme activities and gene expression in carotenoid biosynthesis by physical fields as an emerging strategy. The review aims to provide a theoretical basis for the targeted regulation of carotenoid enrichment during maize germination, thereby facilitating the development of related functional foods and expanding their applications in the health field.