[Objective] To reveal the coordinated evolution patterns and obstacle factors of the water-energy-food（WEF） nexus in the middle reaches of the Yellow River basin. [Methods] An evaluation index system for the WEF nexus was established. The entropy weight method was used to calculate the weights of the indicators, and the coordinated evolution characteristics of the system from 2010 to 2021 were analyzed. A diagnostic model of obstacle degree was applied to identify the key constraining factors.[Results] The temporal evolution of the WEF nexus in the study area exhibited three typical stages, with 2017 identified as a key turning point. The sustainability index shifted from steady growth to rapid improvement, with the regional maximum increasing from 0.56 to 0.74. The spatial pattern transformed from a "concave" distribution in 2010 to a "convex" one in 2020, reflecting a regional development trend of "prominent advantages in Shaanxi, steady improvement in Shanxi, and relative lag in Inner Mongolia". Baoji City, in particular, achieved a remarkable 117.60% increase in its sustainability index, whereas traditional industrial cities such as Taiyuan and Baotou experienced negative growth. Obstacle factors demonstrated significant regional disparities and dynamic variations. In Inner Mongolia, the primary constraints shifted from industrial chemical oxygen demand（COD） emissions（9.64%） to dual limitations of agricultural irrigation water use and energy consumption. In Shaanxi, the obstacle degree of industrial COD emissions significantly decreased（from 11.71% to 0.26%）, while the constraint posed by energy consumption increased（10.13%）. In Shanxi, the obstacle degree of industrial COD emissions sharply dropped（from 13.90% to 0.15%）. [Conclusion] The coordinated development of the WEF nexus is dynamically regulated by resource use efficiency and industrial structure. The proposed method for identifying region-specific obstacle factors can provide decision-making support for ecological conservation and optimized resource allocation in the Yellow River Basin.