Inflammatory bowel disease (IBD) is a chronic gastrointestinal disorder with a complex pathogenesis and limited therapeutic options. Nanozymes, particularly carbon dots (CDs), offer a novel strategy for treating IBD owing to their enzyme-like catalytic activities and high biocompatibility. Traditional Chinese medicine (TCM) involves the use of rich sources of bioactive compounds with anti-inflammatory and antioxidant properties; however, the clinical application of these compounds is often hampered by their low solubility and bioavailability. This review explored the effects of TCM-derived CD nanozymes (TCM-CDs) on enhancing IBD therapy. The classification, green synthesis methods, and unique mechanisms of TCM-CDs, including reactive oxygen species scavenging, regulation of gut microbiota, and modulation of inflammatory signaling pathways, were summarized. Furthermore, the current limitations in material synthesis, biological uncertainty, and clinical translation challenges were discussed; an AI-driven framework was developed for future precision design and personalized IBD treatment. TCM-CDs represent promising nanoplatforms that synergize the multitarget therapeutic advantages of TCM with the catalytic versatility of nanozymes, offering new insights into next-generation IBD therapeutics.