Universal Test-Time Adaptation (UTTA) tackles the challenge of handling both class and domain shifts in unsupervised settings with stream testing data. Currently, most UTTA methods can only deal with minor shifts and heavily rely on heuristic approaches. To advance UTTA under dual shifts, we propose a novel Active Universal Test-Time Adaptation (AUTTA) framework, Exposing Mixture and Annotating Confusion (EMAC), which incorporates active human annotation into the UTTA setting. To select appropriate samples for annotation in AUTTA, we first identify the mixed regions of target domain samples under dual shifts, highlighting potential candidate samples. We then design a reward-guided active selection strategy to prioritize annotating the most representative samples within this set, maximizing annotation effectiveness. Additionally, to balance the use of pseudo-labels with the limited number of annotations, we propose an adaptation objective designed to address the adaptation imbalance caused by annotation scarcity. Extensive experiments show that the proposed AUTTA approach significantly improves performance and achieves state-of-the-art.