There is a plethora of electrochemical biosensors developed for ultrasensitive detection of clinically-relevant biomarkers. However, many of these systems lose their performance in heterogeneous clinical samples and are too complex to be operated by end users at the point-of-care (POC), prohibiting their commercial success. Integration of biosensors with sample processing technology addresses both of these challenges; however, it adds to the manufacturing complexity and the overall cost of these systems. Herein, we review the different components of a biosensor and avenues for creating fully-integrated systems. In the context of integration, we focus on discussing the trade-offs between sensing performance, cost, and scalable manufacturing to guide the readers toward designing new electrochemical biosensors with commercialization potential.