The discharge of organic pollutants in wastewater poses a threat to the ecological environment and human health, and membrane separation is one of the simplest and most effective treatment technologies. In recent years, MXene has become a fundamental unit for constructing high-performance membranes due to its unique "accordion" layered structure and its structural controllability. Meanwhile, various physical and chemical methods are used to precisely regulate and optimize the design of interlayer channels, in order to further enhance the permeability, selectivity, and stability of MXene membranes. In this article, bibliometrics was used to statistically analyze the research progress of MXene membranes at home and abroad. The evolution of MXene membrane structure was encapsulated, and the regulatory strategies for MXene membrane structure, including intercalation, cross-linking, self-assembly, and surface modification, were elaborated in detail. The separation efficiency and mechanism of MXene membrane for typical organic pollutants such as dyes and antibiotics are summarized and analyzed. Finally, based on the current research results, it was proposed to conduct in-depth research from the aspects of development, engineering application, and computer simulation, providing theoretical basis and technical support for the practical application of MXene membranes.