Nitrate pollution threatens environmental safety and human health. Clay mineral materials with high reserves, easy access, low price and high efficiency have great potential as nitrate removers. Starting from the characteristics and sources of nitrate, the natural clay minerals used for nitrate removal in water, including kaolin, attapulgite, illite, sepiolite, and bentonite, were introduced. They generally have the problems of low ion exchange capacity and low selective adsorption. Then, the commonly used modification method and composite method were summarized. Both methods can effectively improve the nitrate removal ability of clay mineral materials. Modification technology can improve its surface properties, adjust the type and quantity of surface functional groups and the effect of surfactant modification is better. Compounding technology can broaden its functionality and obtain more operability and performance improvement, among which the compounding with bimetallic ions or chitosan is a better way. Further, the toxicity of the clay mineral material was analyzed. It is concluded that it has the potential to prepare composites with low toxicity and high biocompatibility, but the selection and concentration of modifiers need to be strictly controlled. In the end, the future research focus and development direction of clay mineral materials in nitrate removal were prospected. Theoretical support and references are provided for the development of new clay mineral materials for nitrate removal.