Some drug molecules with strong chemical activity are unstable in the biological environment and difficult to reach the target, so no matter how good the drug is, it cannot completely prove its efficacy. And drugs need good vectors to help them deliver to their target, where they work best. In recent years, covalent organic frameworks (COFs) have been developed for drug delivery applications due to their regular pore structure, good biocompatibility, topological controllability, and modifiability. In the process of drug delivery, COFs have many advantages such as high drug adsorption capacity, good stability in the biological environment, strong targeting of lesions, and weak cytotoxicity. At present, a lot of work using COFs as drug molecular carriers has been reported, and this minireview summarizes the mechanism of COFs drug delivery and related applications in recent years (drug adsorption and release), by which we expect to achieve more ideas for the future design of drug delivery related COFs and push forward the development of COFs in drug delivery.