Patients with metabolic syndrome (MS) are at potential risk for cardiovascular disease and have received increasing public and medical attention. Studies have shown that regular physical exercise can effectively regulate metabolic indicators such as blood pressure, blood sugar and blood lipids, and play a positive role in reducing the risk of cardiovascular disease and improving the prognosis of patients. Exercise intensity has been identified as the most important aspect in reducing the risk of cardiovascular death and all-cause mortality in exercise intervention. Therefore, the design of exercise prescription which is both scientific and satisfying individual differences has become the focus of research. Most of the current clinical studies are based on the percentage of exercise intensity as the basis for the formulation of standardized exercise prescription for MS patients, while the studies on the individualized threshold of exercise intensity based on cardiopulmonary exercise test (CPET) are still few. CPET has shown that individualized exercise prescription can effectively reduce body composition index, blood pressure and blood glucose, improve cardiorespiratory function, exercise endurance and quality of life in MS patients. This paper reviewed the development of individualized exercise programs with different intensification according to threshold indexes in CPET, analyzed the intervention effects and possible mechanisms for MS patients and subgroups, and provided certain reference for the formulation and implementation of personalized exercise prescriptions for MS patients, and also provided references for in-depth research on individualized exercise intervention for MS.