A Twitch chatbot can be created to engage with viewers in real-time using Node.js, Twilio Programmable Messaging, and tmi.js. To start, dependencies are installed, including the necessary libraries for interacting with Twitch chat and sending SMS messages. A basic bot is then created that logs incoming chat messages from a specified channel, and responds to specific commands such as "!hello". The bot can also be used to send text messages via Twilio Programmable Messaging, allowing streamers to notify subscribers of important events in real-time. By combining these features, a more advanced Twitch chatbot can be built, potentially integrating with other APIs or adding new features to enhance the user experience.