Macrophages are essential components of the innate immune system. They have high functional plasticity and play an important role in maintaining tissue homeostasis, regulating inflammatory responses and mediating immune-related tissue damage. In recent years, advances in technologies such as single-cell sequencing and spatial transcriptomics have expanded the understanding of macrophages from the traditional M1/ M2 polarization paradigm toward a more multidimensional spectrum of functional states. Conse- quently, the roles of macrophages in the initiation and progression of autoimmune diseases have attracted increasing attention. This re- view summarizes recent advances in macrophage functional states in autoimmune diseases. First at all, it provides an overview of the origin, developmental regulation and functional plasticity of macrophages. Secondly, it summarizes the common characteristics of mac- rophages in various autoimmune diseases including enhanced pro-inflammatory function, impaired clearance of apoptotic cells, abnor- mal metabolic reprogramming and persistent chronic inflammatory microenvironment. Finally, it analyzes the functional status and po- tential mechanisms of action of disease-associated macrophages in rheumatoid arthritis, systemic lupus erythematosus, idiopathic in- flammatory myopathy, multiple sclerosis and inflammatory bowel disease. At the same time, current therapeutic strategies targeting macrophage-related pathways are summarized. Future directions for precision intervention based on disease-associated macrophage states are explored. In conclusion, we aim to further understand the role of macrophage dysfunction in autoimmune diseases and provide a reference for disease mechanism research and treatment strategy exploration through summarization of relevant research in recent years.