Accurate monocular 3D object detection (M3OD) is pivotal for safety-critical applications like autonomous driving, yet its reliability deteriorates significantly under real-world domain shifts caused by environmental or sensor variations. To address these shifts, Test-Time Adaptation (TTA) methods have emerged, enabling models to adapt to target distributions during inference. While prior TTA approaches recognize the positive correlation between low uncertainty and high generalization ability, they fail to address the dual uncertainty inherent to M3OD: semantic uncertainty (ambiguous class predictions) and geometric uncertainty (unstable spatial localization). To bridge this gap, we propose Dual Uncertainty Optimization (DUO), the first TTA framework designed to jointly minimize both uncertainties for robust M3OD. Through a convex optimization lens, we introduce an innovative convex structure of the focal loss and further derive a novel conjugate loss, enabling label-agnostic uncertainty weighting and balanced learning for high-uncertainty objects. In parallel, we design a semantic-aware normal field constraint that preserves geometric coherence in regions with clear semantic cues, reducing uncertainty from the unstable 3D representation. This dual-branch mechanism forms a complementary loop: enhanced spatial perception improves semantic classification, and robust semantic predictions further refine spatial understanding. Extensive experiments demonstrate the superiority of DUO over existing methods across various datasets and domain shift types. The code will be publicly available.