As a pivotal direction for next-generation communication technologies, semantic communication focuses on the meaning and utility of information, significantly enhancing communication efficiency and demonstrating revolutionary potential to drive a paradigm shift from modal transmission to knowledge-driven interaction. However, as systems increasingly rely on shared knowledge bases and deep learning models, the security boundary has extended from the traditional bit layer to the cognitive layer, exposing networks to novel threats such as cross-layer coupling and multi-modal poisoning. By systematically reviewing literature from the past three years, this study constructed a four-dimensional security classification architecture covering “Data Privacy, Model Endogeneity, Transmission Physics, and Knowledge Cognition” comprehensively analyzing the vulnerability mechanisms of semantic communication in adversarial environments. Specifically, this paper highlighted high-level cognitive threats, including Knowledge Graph structural poisoning and inference chain manipulation, and systematically evaluated emerging defense technologies based on cognitive immunity, dynamic trust graphs, and quantum empowerment. Furthermore, combined with typical scenarios such as the Internet of Things and the Internet of Vehicles, the practical deployment challenges of lightweight and anti-jamming security mechanisms were analyzed. Finally, this paper proposed future research directions, including endogenous cognitive security, zero-trust semantic architecture, and cross-domain fusion defense, aiming to provide theoretical support and technical guidance for building a secure, trustworthy, and robust 6G semantic communication system.