The fabrication of zinc oxide-based nanomaterials (including natural and synthetic polymers like sulfated polysaccharide, chitosan, and polymethyl methacrylate) has potential to improve oral cancer treatment strategies. This comprehensive review explores the diverse synthesis methods employed to fabricate zinc oxide nanomaterials tailored for oral cancer applications. Several synthesis processes, particularly sol–gel, hydrothermal, and chemical vapor deposition approaches, are thoroughly studied, highlighting their advantages and limitations. The review also examines how synthesis parameters, such as precursor selection, the reaction temperature, and growth conditions, influence both the physicochemical attributes and biological efficacy of the resulting nanomaterials. Furthermore, recent advancements in surface functionalization and modification strategies targeted at improving the targeting specificity and pharmaceutical effectiveness of zinc oxide-based nanomaterials in oral cancer therapy are elucidated. Additionally, the review provides insights into the existing issues and prospective views in the field, emphasizing the need for further research to optimize synthesis methodologies and elucidate the mechanisms underlying the efficacy of zinc oxide-based nanoparticles in oral cancer therapy.