This comprehensive review explores recent advancements in heavy metal remediation techniques, focusing on the utilization of cellulose–silica composites and tailored surface modification techniques. We examine the synthesis strategies and properties of cellulose–silica adsorbents, highlighting their enhanced adsorption capacities and structural robustness for removing heavy metal pollutants from aqueous environments. The review investigates various surface modification approaches, including thiol functionalization, amino acid grafting, and silane coupling agents, for optimizing the surface chemistry and morphology of cellulose–silica composites. Mechanistic insights into the adsorption processes and kinetics of modified adsorbents are discussed, along with considerations for optimizing adsorption performance under different environmental conditions. This review provides valuable perspectives on the development of effective adsorbent materials for sustainable heavy metal remediation applications.