Optimally increasing the catalytic activity of Co3O4-based materials is crucial for promoting their practical applications for acetone detection; however, this still remains challenging. Herein, a strategy is proposed in this work to increase the catalytic activity of Co3O4 toward the oxidation of acetone through the synergistic effect of boron doping and chemical reduction, which can substantially improve the sensing performance for acetone detection. The characterization results confirm that the present strategy facilitates the formation of more oxygen vacancies and increases the content of Co2+ ions serving as active sites. As expected, the optimal sensor yields a higher response . To extend the practical application to the auxiliary diagnosis of diabetes through exhaled breath, the optimal sensors distinguished between acetone concentrations in the breath of healthy individuals and in the simulated breath of patients with diabetes. Detailed gas-sensing measurements reveal that the enhanced acetone sensing performance is attributed to the increased catalytic activity of materials for oxidation of acetone by the Mars–van Krevelen, Langmuir–Hinshelwood, and Eley–Rideal mechanisms. This study provides new insights into the fabrication of high-performance metal oxide-based gas sensors by improving the catalytic activity of sensing materials.