With the rapid development of the chemical and pharmaceutical industries, fluoride ion contamination has become an increasingly serious issue in recent years. Addressing large volumes of fluoride-containing wastewater has emerged as a critical research topic. This article begins by discussing the harmful effects of fluoride ions on human health and then reviews various technologies for controlling fluoride ion pollution in water, with a focus on adsorption methods. Among the minerals employed in adsorption, attapulgite stands out due to its excellent physicochemical properties, abundant reserves, and low cost, making it a widely used material in the treatment of fluoride-containing wastewater. However, a comprehensive evaluation of attapulgite-based adsorbent materials in fluoride wastewater treatment has yet to be established. This review summarizes the preparation, application development, and adsorption mechanisms of attapulgite-based composite materials. It also offers constructive suggestions for fully utilizing attapulgite's inherent properties, emphasizing the potential for regeneration and recycling, to inspire new approaches for developing more efficient attapulgite-based fluoride ion adsorbents in the future.