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We report a fully integrated, low-cost, autonomous optical nanomotion analysis platform for rapid phenotypic antimicrobial susceptibility testing. The system combines a 3D-printed OpenFlexure microscope with Raspberry Pi-based autofocus, time-lapse acquisition, and onboard image processing. Nanomotion is quantified from frame-to-frame intensity fluctuations in detected single cells, without labels or external computation. Antibiotic-sensitive strains show a marked reduction in nanomotion within 2–3 h, whereas resistant strains maintain stable signals. Dose–response and nutrient-modulation experiments confirm that the signal reflects metabolic activity. This platform enables scalable, growth-independent phenotypic testing for decentralized and resource-limited settings.