CNC machine tools play an important role in manufacturing and are characterized by high total energy consumption and low energy efficiency. The energy consumption characteristics of the machine tool itself determine the total energy consumption and pollutant emission during its service life. Therefore, it is particularly important to design machine tools with energy consumption as the optimization target to analyze the composition of energy consumption and related characteristics, build a corresponding model based on reliability verification, guide the structural design and optimization according to the model, and ultimately use the evaluation system to evaluate and judge the overall energy consumption. In this paper, from four perspectives—the composition of the energy consumption of machine tools, modeling methods, design and optimization methods, and evaluation methods—with energy consumption optimization as the entry point, we analyze the research on CNC machine tools based on energy consumption around the world. The research results indicate that we should look forward to the role of energy consumption in the design of machine tools.