Micro diamond tools are indispensable for the efficient machining of microstructured surfaces. The precision in tool manufacturing and cutting performance directly determines the processing quality of components. The manufacturing of high-quality micro diamond tools relies on scientific design methods and appropriate processing techniques. However, there is currently a lack of systematic review on the design and manufacturing methods of micro diamond tools in academia. This study systematically summarizes and analyzes modern manufacturing methods for micro diamond tools, as well as the impact of tool waviness, sharpness, and durability on machining quality. Subsequently, a design method is proposed based on the theory of cutting edge strength distribution to enhance tool waviness, sharpness, and durability. Finally, this paper presents current technical challenges faced by micro diamond tools along with potential future solutions to guide scientists in this field. The aim of this review is to contribute to the further development of the current design and manufacturing processes for micro diamond cutting tools.