Abstract The rapid growth of connected medical devices generates massive volumes of heterogeneous health data that must be processed and transmitted in real time. In such environments, minimizing latency and energy consumption remains a critical challenge for next-generation health monitoring systems. Existing reinforcement learning and optimization methods for intelligent communication networks face several challenges, including slow convergence, high computational overhead, and inefficiency in handling task prioritization. To resolve these issues, this work develops a chaotic dung beetle optimization-boosted multi-agent deep reinforcement learning that jointly optimizes communication reliability, computational efficiency, and task prioritization. A reward function is designed to jointly minimize delay, energy usage, and system cost while preserving information freshness. Specifically, the dung beetle optimization process is combined with a piecewise linear chaotic map to enhance population diversity, which significantly improves search space exploration and leads to faster convergence and higher solution quality. The proposed algorithm enhances the exploration capability of multi-agent deep reinforcement learning through the integration of chaotic dung beetle optimization, enabling more accurate and reliable decision-making in real-world applications. Extensive experiments demonstrate that the proposed chaotic dung beetle optimization-boosted multi-agent deep reinforcement learning model achieves superior performance compared to baseline algorithms. Specifically, it reaches an accuracy of over 97.00% with rapid convergence, reduces system cost under varying health data sizes and Medical Internet of Things devices, and maintains robust scalability across diverse workloads. Moreover, the model achieves significant reductions in communication latency and energy consumption as central processing unit cycles and bandwidth increase, while effectively prioritizing high-criticality tasks.