Fluoroquinolones (FQs) are a class of antibiotics that pose significant environmental and health risks due to their toxicity, persistence, and contribution to antibiotic resistance. Among various removal methods, adsorption using nanomaterials has emerged as an efficient, cost-effective, and reusable approach. This review evaluates the adsorption capabilities of nanoparticles and nanocomposites for FQ removal, focusing on key mechanisms and influential factors. FQs, particularly norfloxacin, are prevalent in aqueous environments, with nanomaterials demonstrating exceptional potential for their removal. The Langmuir isotherm and pseudo-second-order kinetic models best describe the adsorption process. Adsorption of fluoroquinolones (FQs) is influenced by factors such as pH, FQ concentration (20–40 mg/L), adsorbent dose (5–20 g/L), temperature (15–35 °C), contact time (30–180 min), and the presence of competing substances like inorganic salts. Optimal adsorption occurs at pH values between pKa1 and pKa2, where electrostatic interactions are maximized. Adsorption efficiency increases with adsorbent dose up to a threshold, beyond which capacity declines due to site underutilization. Temperature affects adsorption through physisorption and chemisorption, with varying results in different studies. Inorganic salts influence adsorption via electrostatic competition and the salting-out effect. The primary adsorption mechanisms include electrostatic interactions, π–π donor–acceptor interactions, and hydrophobic forces, with electrostatic interactions dominant (72.3% of studies). Nanomaterials exhibit excellent reusability, making them promising for wastewater treatment. Challenges remain, including multi-component adsorption studies, improved regeneration techniques, and understanding environmental impacts. Future research should focus on optimizing nanomaterials for real-world applications, exploring functional groups, and conducting pilot-scale studies.