AlGaN/GaN high electron mobility transistors (HEMTs) have demonstrated their extraordinary potential in developing solid-state microsensors for detecting gases, metal ions, anions, biomolecules, and other substances due to their excellent chemical stability, high surface charge sensitivity, high temperature-tolerance performance, and low power consumption characteristics. In this paper, only three types of AlGaN/GaN HEMT-based sensors used for detecting the pH value, heavy metal ions, and harmful anions, which are suitable for water quality monitoring, will be discussed. First, we introduce the structural design, detection principle, and fabrication processes of AlGaN/GaN HEMT-based sensors. Then, surface functionalization methods for the gate region, sensing mechanisms, and the sensitivity and selectivity performances based on different gate region treatments are reviewed and analyzed. Finally, some challenging problems that hinder the practical application of the sensors are proposed.