This study presents the development and investigation of a 3D double-sided fabric with a concave−convex lattice appearance created using advanced knitting technology. Nine distinct 3D knitted fabric samples were meticulously designed to explore the effects of fabric concavity, convexity, and raw materials on the thermal-moisture comfort of the textiles. Experimental analyses were conducted to assess various parameters including moisture permeability, air permeability, moisture management, evaporation, and thermal comfort performance. Additionally, theoretical models were employed to predict the capillary pressure generated by the fabric. The findings reveal that the moisture absorption capability of the yarn significantly influences the moisture vapor penetration and water evaporation of the fabric. Moreover, the type of yarn, such as staple fiber yarn, directly affects the heat dissipation performance of the textile. Structural variations were also considered, and it was observed that fabrics exhibiting pronounced concave and convex shrinkage patterns facilitate unidirectional liquid transportation and prevent reverse osmosis. However, these structures adversely affect moisture permeability, breathability, and water evaporation. Furthermore, theoretical model calculations demonstrate the substantial influence of the capillary pressure on moisture conductivity. This innovative approach provides valuable insights for the development of textiles with superior sweat management capabilities as well as clothing that maximizes personal comfort across multiple application scenarios.