Introduction: The beginning of exosome biosynthesis is marked by the emergence of the initial endosomes through the inward splitting of the plasma cell membrane. This process is facilitated through the endosomal categorization complex essential for transport, which is also involved in the production of different extracellular vesicles. Exosomes are naturally occurring nanosized vesicles found in all bodily fluids and can be successfully extracted from preserved biological materials, while maintaining their structural integrity. Methods: The articles published recently in high-quality journals (Science Direct, Springer, Institute of Electrical and Electronics Engineers (IEEE), and Taylor & Francis) indexed in various indexing sources such as Scopus, Web of Science, PubMed, Google Scholar, and so on were collected using keywords such as fluid biopsy (FB) exosomes, endosomes, and noncommunicable diseases (NCDs) treatment, new biomarkers, and treatment. Discussion: In recent years, exosomes have emerged as an exciting option for “FB” that has demonstrated significant potential in the areas of noninvasive medical testing, predictions, as well as tracking responses to therapy for noncommunicable diseases. Nevertheless, specific constraints need to be addressed to expand the application of exosome-based FB as a widely accepted and reliable testing method in typical medical facilities. Conclusion: This review provides a comprehensive overview of our present understanding of exosomes to be an FB method for diagnosing, predicting outcomes, and tracking treatment responses in NCDs. It also discusses the main constraints, innovations in technology, as well as future possibilities of using this application in medical treatment.