Adipose stem cell-derived apoptotic bodies (ADSC-ABs) have shown potential in immunomodulation and tissue regeneration, particularly for diabetic wound therapy. However, their application is limited by unclear regulatory mechanisms, rapid clearance, and short tissue retention. Mao et al. discovered that ADSC-ABs restore inflammatory balance in macrophages by modulating the JAK-STAT pathway and identified miR-20a-5p as a crucial factor in maintaining homeostasis in diabetic wounds. To address rapid clearance, they developed methacrylate-anhydride gelatin (GelMA) microspheres (GMS) for controlled release of ABs. The optimized system, ABs@GMSs, effectively balanced macrophage polarization, delayed AB clearance, and improved diabetic wound healing by promoting vascularization and reducing inflammation. This study highlights the importance of delayed AB clearance and the regulatory role of ADSC-ABs in macrophage polarization, offering insights for novel therapies in diabetic wound healing.Adipose stem cell-derived apoptotic bodies (ADSC-ABs) have shown potential in immunomodulation and tissue regeneration, particularly for diabetic wound therapy. However, their application is limited by unclear regulatory mechanisms, rapid clearance, and short tissue retention. Mao et al. discovered that ADSC-ABs restore inflammatory balance in macrophages by modulating the JAK-STAT pathway and identified miR-20a-5p as a crucial factor in maintaining homeostasis in diabetic wounds. To address rapid clearance, they developed methacrylate-anhydride gelatin (GelMA) microspheres (GMS) for controlled release of ABs. The optimized system, ABs@GMSs, effectively balanced macrophage polarization, delayed AB clearance, and improved diabetic wound healing by promoting vascularization and reducing inflammation. This study highlights the importance of delayed AB clearance and the regulatory role of ADSC-ABs in macrophage polarization, offering insights for novel therapies in diabetic wound healing.