Improving nitrogen use efficiency (NUE) in wheat is critical for addressing the dual challenges of global food security and environmental sustainability. Globally, only 42%-47% of applied nitrogen (N) fertilisers taken up by crops, with remainder lost to the environment, driving soil and water pollution, greenhouse gas emissions, and ecological imbalances. This review provides a comprehensive synthesis and integrative framework- integrating agronomic practices, advanced remote sensing and genomic approaches to enhance wheat NUE. We first examine the physiological basis of NUE, emphasising the synergy between photosynthetic carbon assimilation and N metabolism, the critical role of Rubisco in carbon-nitrogen coupling, and the temporal dynamics of N uptake, transport, and remobilisation throughout the wheat growth cycle. The temporal mismatch between source-sink N partitioning during grain filling emerges as a major physiological constraint limiting NUE in modern high-yielding varieties. We then explore transformative advances in remote sensing technologies, highlighting the paradigm shift from traditional vegetation indices to physiological sensing approaches. Through integration of multispectral imaging, LiDAR, thermal infra-red sensing, and solar-induced chlorophyll fluorescence, coupled with three-dimensional radiative transfer models and machine learning algorithms, these technologies enable non-destructive, real-time monitoring of crop N status while overcoming spectral-structural ambiguity and saturation limitations. From a genomic perspective, we synthesise recent progress in quantitative trait loci mapping and genome-wide association studies (GWAS), identifying key genetic loci controlling root architecture, N uptake transporters (NRT/AMT families), and grain filling efficiency. Multi-omics integration-spanning genomics, transcriptomics, and metabolomics-reveals temporal genetic networks distinguishing short-term nitrogen signalling responses from long-term adaptive remodelling, with genes such as TaNAC2-5A, TaNPF6.2, and QMrl-7B emerging as promising targets for molecular breeding. High-throughput phenotyping platforms enable time-series GWAS analysis, capturing developmental dynamics and genotype × environment interactions that traditional approaches miss. Finally, we discuss sustainable N management strategies, including enhanced efficiency fertilisers, precision application technologies, and soil health optimisation. By integrating these multidisciplinary approaches within a Genotype × Environment × Management framework, this review provides a roadmap for developing climate-smart, N-efficient wheat varieties and precision N management systems that simultaneously enhance productivity, reduce environmental footprints, and ensure sustainable agricultural intensification.