China is in a critical period of high-quality development. The innovation and development of small and medium-sized manufacturing enterprises is the necessary driving force to achieve high-quality development. This paper takes 31 provinces, autonomous regions and municipalities directly under the central government in 2016-2020 as samples to discuss the combination mode and implementation effect of different types of policies for innovation and development of manufacturing SMEs from the meso and micro level by using the method of qualitative comparative analysis (QCA). The results show that: (1) the intermediary policy of technology transfer system is the necessary condition for the innovation and development of small and medium-sized manufacturing enterprises; (2) the innovation and entrepreneurship policy based on direct support, the fiscal and taxation financial policy with tax reduction and fee reduction and direct financial support as the main body, and the science and technology service intermediary policy based on technology transfer system construction can have five policy combinations Promote the innovation and development of small and medium-sized enterprises. The research results can provide reference for the formulation and improvement of innovation and development policies for national manufacturing SMEs.