Accurate diagnosis of crop water demand is a core challenge in alleviating agricultural water scarcity. Traditional diagnostic methods, which rely mainly on soil moisture sensor monitoring or empirical models based on meteorological data, suffer from limitations such as insufficient spatiotemporal representativeness and an inability to reflect crop physiological status in real time, leading to an annual water waste of 10–30%. Therefore, developing technologies that enable real-time, non-destructive, and precise monitoring of crop water status is crucial. In recent years, the rapid advancement of high-throughput phenotyping technology has provided revolutionary tools to address this challenge. By integrating multi-source sensors (e.g., thermal infrared and hyperspectral imaging), multi-dimensional response characteristics of crops under water stress can be rapidly acquired. This paper systematically reviews research progress in using high-throughput phenotyping to obtain water-sensitive phenotypic traits and construct crop water demand diagnosis models. It focuses on: (1) the connotation and acquisition techniques of key water-sensitive phenotypic indicators, such as canopy temperature, spectral indices, and chlorophyll fluorescence; (2) the advantages, limitations, and fusion strategies of multi-platform data acquisition systems, including unmanned aerial vehicles (UAVs), ground mobile platforms, and satellite remote sensing; and (3) the construction methods, performance evaluation, and practical application cases of diagnostic models based on machine learning (e.g., Random Forest, XGBoost), deep learning (e.g., CNN, LSTM), and mechanism-coupled models. The innovation of this review lies in its systematic integration of the entire technological chain—"phenotyping acquisition → model construction → decision-making"—while identifying current research challenges, including field environmental complexity, model generalization capability, data barriers, and interpretability. Future development pathways are proposed, focusing on low-cost sensing, explainable AI, multi-source data fusion, and cloud-edge collaborative decision systems. This review aims to provide a systematic theoretical and practical reference for water management in precision irrigation and smart agriculture.