Visible light-induced alkyne-carbonyl metathesis has emerged as one of the key tools for constructing α, β-unsaturated carbonyl compounds. Meanwhile, visible light-induced multicomponent organic reactions, featuring high atom economy and mild reaction conditions, have become an important strategy for building complex molecular architectures. Integrating these two strategies-specifically, incorporating visible light-induced alkyne-carbonyl metathesis (ACM) into multicomponent reactions-provides a new pathway for the efficient synthesis of functional aldehydes/ketones while balancing reaction efficiency and atom economy. The review focuses on the research progress of visible light-induced multicomponent reactions of nucleophiles with p-quinone methide (p-QM) intermediates in situ generated by ACM. Initially, this review mainly summarizes visible light-induced multicomponent racemic coupling reactions with alkynes, quinones, and various nucleophiles. Thereafter, it further introduces the application of this strategy in the asymmetric synthesis of chiral compounds and discusses its substrate scope and reaction mechanisms in the construction of complex molecules. This review also highlights the current limitations and challenges within this field and provides an outlook on potential future research directions.