With the intensification of the global energy crisis and environmental pollution issues, electric vehicles have become the future trend in automotive power due to their high energy efficiency and low emissions. The heat generated by batteries imposes limitations on their performance. Consequently, it is essential to gain a comprehensive understanding of the factors contributing to this heat generation and to devise and implement effective countermeasures. Addressing these issues is critical for optimizing battery performance and ensuring its safety. This review starts with a brief overview of the factors contributing to battery heat generation. It then delves into direct cooling battery thermal management technology, which utilizes the principle of refrigerant evaporation to absorb and dissipate heat effectively. This approach delivers superior cooling efficiency compared to traditional liquid and air cooling systems. Direct cooling systems are distinguished by their more compact design and faster response times, contributing to more effective thermal management and improved performance. By examining recent literature, this work provides a comprehensive review of the research developments concerning direct cooling systems. It includes an in-depth analysis of the structure design, cold plate design, and optimization strategies for various system parameters. It also highlights how the careful selection of refrigerant properties, along with precise adjustments to system parameters and cold plate configurations, can lead to significant enhancements in temperature uniformity under high-rate charge and discharge conditions. These improvements are crucial for extending the battery's operational lifespan and ensuring its safe and reliable performance. Future research efforts on direct cooling battery thermal management systems should prioritize two key areas: the optimization of the direct cooling plate system's design and parameters, and the development of new, highly efficient, and environmentally friendly refrigerants. Focusing on refining the structural design and operational parameters of direct cooling plates will help improve their performance and adaptability.