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Khelif, who won by unanimous decision, is the first Algerian woman to earn an Olympic boxing title and the first boxer from her country to claim gold since Hocine Soltani at Atlanta 1996.
Khelif, a silver medallist at the 2022 Worlds, and Taiwanese boxer Lin Yu-ting have been in the spotlight in recent days as part of a gender row that has dominated headlines and been the subject of much discussion on social media platforms.
Khelif, whose participation in the Games was permitted by the IOC and had divided boxers, landed multiple punches in the first 30 seconds before a powerful right to Carini's nose prompted the Italian to raise her hand and return to her corner.
Algeria beat hosts Qatar 2-1 in a dramatic second semifinal to set up a title clash with neighbours Tunisia.
Algeria won the Africa Cup of Nations for the second time on Friday when a freak second-minute goal by Baghdad Bounedjah gave them a 1-0 win over gallant Senegal in the final.