Adiponectin, a peptide secreted primarily by adipocytes, plays a crucial role in preventing obesity-related diseases such as insulin resistance, type 2 diabetes, and cardiovascular disease. It acts through two isoforms of adiponectin receptors (AdipoR1 and AdipoR2) and has direct effects on liver, skeletal muscle, and the vasculature. Adiponectin exists in the circulation as varying molecular weight forms, with high-molecular-weight (HMW) complexes being the most bioactive. Recent studies have shown that adiponectin administration in humans and rodents has insulin-sensitizing, anti-atherogenic, and anti-inflammatory effects, and can also decrease body weight. The current review summarizes the regulation and function of adiponectin in obesity, insulin resistance, and cardiovascular disease, highlighting its potential as a therapeutic target for these conditions.Adiponectin, a peptide secreted primarily by adipocytes, plays a crucial role in preventing obesity-related diseases such as insulin resistance, type 2 diabetes, and cardiovascular disease. It acts through two isoforms of adiponectin receptors (AdipoR1 and AdipoR2) and has direct effects on liver, skeletal muscle, and the vasculature. Adiponectin exists in the circulation as varying molecular weight forms, with high-molecular-weight (HMW) complexes being the most bioactive. Recent studies have shown that adiponectin administration in humans and rodents has insulin-sensitizing, anti-atherogenic, and anti-inflammatory effects, and can also decrease body weight. The current review summarizes the regulation and function of adiponectin in obesity, insulin resistance, and cardiovascular disease, highlighting its potential as a therapeutic target for these conditions.