Climate change risk response is a great challenge in global economic sustainable development and carbon neutrality management. Taking China’s A-share listed companies from 2016 to 2022 as the sample, this paper explores the impact of the climate change risks of enterprises on the decision-making on key audit matters (KAMs). Empirical results show that under the audit risk response driven by climate change, annual report auditors are more cautious in KAM decision-making in enterprises with a higher level of climate change risks, manifested as being more likely to issue KAM decisions related to climate change and matching KAM decisions with climate business risks, and the risk control effectiveness of KAMs is mainly reflected in transition climate risks, while the impact of physical climate risks is not significant. Mechanism testing shows that climate change will strengthen the transmission of risk factors in enterprises and increase audit investment, thereby enhancing the prudence of KAM disclosure. Heterogeneity analysis indicates that KAM disclosure decisions under climate change risk response are more pronounced in enterprises with poorer carbon neutrality performance, in high-carbon industries, and with higher climate policy uncertainty. Economic consequence analysis shows that the risk control decisions of KAMs driven by climate change have a positive effect on audit quality and capital market stabilization. This paper enriches the research on the risk control effectiveness of KAMs disclosure in new audit reports from the perspective of climate change at the enterprise level, and has important value for the supervision on climate-related information disclosure in enterprises and the quality management of sustainable audit business in audit firms during the process of carbon neutrality.