Osteoporosis (OP) is a systemic and retrogressive disease characterized by decreased bone density and fragile bone microstructure. Extracellular vesicles (EVs), a cell‐free system with a phospholipid bilayer released by cells that cannot be replicated, have unique nanostructure, stable drug‐loading capacity, and good biocompatibility, playing an important role in regulating the gut‐skeletal axis. A growing body of research demonstrates that gut microbiota (GM) influence the development of OS, while bacteria‐derived EVs (BEVs) have become a new dialogue medium between the gut and bone. Additionally, organoids are 3D cell clusters in vitro that highly simulate the structure and function of corresponding organs. Intestinal organoids‐derived EVs (IOEVs) serve as another promising communication medium between the gut and bone due to their significant physiological effects. Herein, three types of gut‐bone axes, including the traditional, BEVs‐based, and IOEVs‐based gut‐bone axes are innovatively proposed. The impact of the BEVs‐based and IOEVs‐based gut‐bone axes on OP is focused. The comprehensive summary of three types of gut‐bone axes will reveal the relationship between intestinal and bone and provide new solution to OP therapy.