Horizontal carbon compensation served as a crucial mechanism for advancing regional sustainable development and realizing China's "dual carbon" objectives. This study conducted a comprehensive assessment of the Yangtze River Delta (YRD) region, analyzed carbon budgets, emission efficiency, and sequestration efficiency across 41 cities. We developed and evaluated four distinct compensation frameworks: baseline, economy-oriented, ecology-oriented, and integrated models, subsequently derived actionable implementation strategies. The analysis revealed three key insights: (1) The YRD region exhibited an extremely low carbon budget coefficient of 0.0576, with significant spatial clustering of both emissions and sequestration. Carbon emission hotspots were concentrated in Shanghai, southern Jiangsu, and central Anhui along the Yangtze River, while carbon sequestration hotspots were predominantly located in southern Anhui's mountains, southern Zhejiang, and the agricultural areas of central Jiangsu. (2) Emission efficiency peaked in economically developed urban centers like Shanghai and Suzhou, contrasting with sequestration efficiency leaders such as Lishui and Taizhou. (3) Compensation obligations predominantly fell on high-emission, economically developed areas (e.g., Shanghai, Suzhou), while compensation beneficiaries were primarily carbon sink providers (e.g., Lishui, Huangshan). Under the four carbon compensation schemes, the total compensation funds reached 47.49, 48.229, 54.844, and 55.858 billion yuan respectively. The coordinated scheme with the dual-efficiency adjustment mechanism was better able to balance efficiency and fairness, making it more suitable for promoting regional low-carbon collaborative development. These findings provided empirically grounded policy recommendations for implementing regional carbon compensation mechanisms and advancing low-carbon development strategies.