Let $\Gamma$ be a congruence subgroup of $SL(2, \Bbb Z)$. A cusp is an equivalence of $\Bbb Q\cup\{\infty\}$ under $\Gamma$-action.
What's the meaning of "equivalence $\Bbb Q\cup\{\infty\}$ under $\Gamma$-action?
How to use the above definition to show that $SL(2,\Bbb Z)$ has only one cusp?
For your first question, as you probably know the group $SL(2,\mathbb Z)$ acts on the set $\mathbb Q \cup \{\infty\}$ by the following formula, known as "fractional linear" transformation: given $M = \begin{pmatrix} a & b \\ c & d \end{pmatrix} \in SL(2,\mathbb Z)$, and given $\frac{r}{s} \in \mathbb Q \cup \{\infty\}$ (with $r,s \in \mathbb Z$), we have $$M \cdot \frac{r}{s} = \frac{a \frac{r}{s}+b}{c \frac{r}{s}+d} = \frac{ar+bs}{cr+ds} $$
The "action equation" holds, namely $$M \cdot (N \cdot \frac{r}{s}) = MN \cdot \frac{r}{s} $$ where $MN$ denotes matrix multiplication. Also $$I \cdot \frac{r}{s} = \frac{r}{s} $$ Given a subgroup $\Gamma < SL(2,\mathbb Z)$ (for example, a congruence subgroup), the orbit of $\frac{r}{s}$ under the action of $\Gamma$ is the set $$\mathcal O_\Gamma \left(\frac{r}{s}\right) = \{M \cdot \frac{r}{s} \mid M \in \Gamma\} $$ As a consequence of the action equations, the set of orbits $$\{\mathcal O_\Gamma\bigl(\frac{r}{s}\bigr) \mid \frac{r}{s} \in \mathbb Q \cup \{\infty\}\} $$ is a partition of the set $\mathbb Q \cup \{\infty\}$, meaning that if two orbits are unequal then they are disjoint.
So to answer your first question, the meaning of "equivalence of $\mathbb Q \cup \{\infty\}$ under the $\Gamma$-action" is simply equivalence with respect to the orbit partition, two elements of $\mathbb Q \cup \{\infty\}$ being equivalent if and only if their orbits are equal, if and only if each one is in the orbit of the other.
To answer your second question, what you must prove is that the action of $SL(2,\mathbb Z)$ on $\mathbb Q \cup \{\infty\}$ has just one orbit. Equivalently, you can prove that for every $\frac{r}{s}$ there exists $M \in SL(2,\mathbb Z)$ such that $M \cdot \frac{r}{s} = \frac{0}{1}$. To do this, first cancel all common factors of $r$ and $s$ so that the fraction $\frac{r}{s}$ is in lowest terms, equivalently $$gcd(r,s)=1 $$ It follows that there exist $t,u \in \mathbb Z$ such that $$tr+su=1 $$ Let $$M = \begin{pmatrix} s & -r \\ t & u \end{pmatrix}\in SL(2,\mathbb{Z}) $$