Wearable, flexible sensors based on hydrogel fabrication have recently gained significant attention due to their unique properties. However, developing hydrogel sensors that maintain high sensitivity and work effectively in sub-zero temperatures remains a formidable challenge. Herein, a hydrogel with surfaces featuring randomly distributed microspines is synthesized by combining sodium alginate (SA) and acrylamide (AM) as the hydrogel components. To fabricate a wearable sensor, a highly conductive MXene layer is inkjet-printed onto the surface of the hydrogel microspines. The resulting sensor exhibits a remarkable array of features, including exceptional sensitivity (15.03 kPa−1), a low detection limit (10 Pa), a vast operating range (0.12–70 kPa), rapid response and recovery (40/100 ms), reliable performance (over 1000 cycles), and outstanding resistance to low temperatures (-20 °C). Moreover, this hydrogel-based sensor facilitates the efficient collection of human monitoring data, such as vocal patterns, pulse, and joint movements, even when operating at −20 °C and in ice bath conditions. Importantly, the surface-based inkjet MXene hydrogels could be assembled into a deformable triboelectric nanogenerator (TENG), allowing mechanical energy harvesting. The TENG exhibited peak output voltage and current values of 5 V and 2.5 μA, respectively.