MXenes with unique mechanical, optical, electronic, and thermal properties along with a specific large surface area for surface functionalization/modification, high electrical conductivity, magnetic properties, biocompatibility, and low toxicity have been explored as attractive candidates for the targeted delivery of drugs in cancer therapy. These two-dimensional materials have garnered much attention in the field of cancer therapy since they have shown suitable photothermal effects, biocompatibility, and luminescence properties. However, outstanding challenging issues regarding their pharmacokinetics, biosafety, targeting properties, optimized functionalization, synthesis/reaction conditions, and clinical translational studies still need to be addressed. Herein, recent advances and upcoming challenges in the design of advanced targeted drug delivery micro- and nanosystems in cancer therapy using MXenes have been discussed to motivate researchers to further investigate this field of science.