Biosensors are ubiquitous in a variety of disciplines, such as biochemical, electrochemical, agricultural, and biomedical areas. They can integrate various point-of-care applications, such as in the food, healthcare, environmental monitoring, water quality, forensics, drug development, and biological domains. Multiple strategies have been employed to develop and fabricate miniaturized biosensors, including design, optimization, characterization, and testing. In view of their interactions with high-affinity biomolecules, they find application in the sensitive detection of analytes, even in small sample volumes. Among the many developed techniques, microfluidics have been widely explored; these use fluid mechanics to operate miniaturized biosensors. The currently used commercial devices are bulky, slow in operation, expensive, and require human intervention; thus, it is difficult to automate, integrate, and miniaturize the existing conventional devices for multi-faceted applications. Microfluidic biosensors have the advantages of mobility, operational transparency, controllability, and stability with a small reaction volume for sensing. This review addresses biosensor technologies, including the design, classification, advances, and challenges in microfluidic-based biosensors. The value chain for developing miniaturized microfluidic-based biosensor devices is critically discussed, including fabrication and other associated protocols for application in various point-of-care testing applications.