A combined anaerobic–anoxic–oxic moving bed biofilm reactor (A2O-MBBR) constructed wetlands process was used to treat low carbon-to-nitrogen (C/N) simulated sewage. The results showed that the removal rates of chemical oxygen demand (COD), ammonia nitrogen (NH4+-N), total nitrogen (TN), and total phosphorus (TP) by this process were 94.06%, 94.40%, 67.11%, and 84.57%, respectively, and the concentrations of COD, NH4+-N, TN, and TP in the effluent were lower than the Class I-A standard of GB18918-2002. In the anoxic zone, NH4+-N had an inhibitory effect on phosphorus uptake via phosphorus-accumulating organisms (PAOs). The highest community diversity was observed in the anoxic zone sludge at 24 d. During the water-quality-shock loads stage, microbial community diversity decreased in a combined A2O-MBBR constructed wetlands reactor. At the phylum level, bacteria within the mature activated sludge were dominated by Proteobacteria, while Planctomycetes bacteria were the dominant species in the constructed wetlands. At the genus level, Tolumonas spp. were the dominant species in the 12 d and 24 d constructed wetlands and the anaerobic zone, with relative abundance percentages ranging from 20.24 to 33.91%. In the water-quality-shock loads stage, they were replaced by denitrifying bacteria such as Herbaspirillum spp. Unclassified_Burkholderiales was the dominant species in the constructed wetlands, with a relative abundance of 33.09%.
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