TiO₂ nanomaterials are widely regarded as key materials for photocatalytic degradation of antibiotics. However, current research lacks systematic reviews that critically evaluate inconsistent findings or methodological limitations across studies. Existing mechanistic studies suggest that the synergy between TiO₂ and metal—organic frameworks (MOFs) can enhance charge separation, extend the light absorption range, and utilize the porous structure of MOFs to adsorb pollutants, thereby collectively improving degradation efficiency. Nevertheless, most conclusions are derived from secondary data without substantial original insights. Advanced characterization techniques have partially revealed structure—activity relationships, and strategies such as heterojunction engineering and bandgap modulation have been employed to overcome the inherent limitations of TiO₂. Nonetheless, there remains a notable absence of critical assessment regarding contradictions in experimental results or constraints in current methodologies. Future research should focus on morphology optimization, scalable synthesis routes, and the application of artificial intelligence (AI)-guided material design to facilitate industrial adoption, while also incorporating more primary validation and comparative analyses to resolve existing inconsistencies.