Abstract: The water supply and consumption structure reflects the coordination degree between regional water resources utilization, socio-economic development, and ecological civilization construction.Investigating the characteristics and driving factors of water supply and consumption in the Henan section of the Middle Route Project of the South-to-North Water Diversion is crucial for rational water resource allocation in receiving areas.Based on water supply and consumption data from 12 cities in the receiving areas of Henan section from 2003 to 2022, this study utilized Mann-Kendall test, information entropy principle, and grey correlation theory to analyze the changing trends of water supply and consumption structure, equilibrium degree of water use structure, and driving factors.The results indicated: ① at a 95% confidence level, surface water supply, groundwater supply, and other water sources in the receiving areas showed significant upward, significant downward, and significant upward trends, respectively; agricultural and industrial water use displayed insignificant downward trends, while comprehensive urban-rural living environment water use showed a significant upward trend.② Among the 12 cities, Xuchang City and Luohe City had the highest mean information entropy values (both 1.06), indicating the most balanced water use structure.Hebi City experienced the fastest entropy growth (16.4% increment), while Zhengzhou City showed the most substantial decrease (34.4% reduction).③ Among the 16 driving factors of water use structure, three indicators, namely grain yield, annual precipitation, and the number of enterprises above designated size, demonstrated significantly increased grey correlation degrees with water consumption in corresponding sectors, rising to a range of 0.65~1.0 and reaching high correlation levels.