Adipose-derived stem cell (ADSC) exosomes have shown significant potential in tissue regeneration due to their ability to carry bioactive molecules that regulate inflammation, enhance cell proliferation, and induce angiogenesis. These exosomes, derived from ADSCs, can promote wound healing, musculoskeletal regeneration, dermatology, and plastic surgery, as well as tissue engineering. ADSCs are abundant and easily isolated from adipose tissue, offering a less invasive and more accessible source compared to bone marrow-derived stem cells. They possess multipotency, enabling differentiation into various cell types, and their regenerative properties are mediated by growth factors and cytokines. ADSC-exos can act as cell-free therapies, enhancing tissue repair and regeneration with minimal adverse effects. ADSC-exos are characterized by their ability to modulate immune responses, reduce inflammation, and promote angiogenesis. Their functional properties include the regulation of cell proliferation, differentiation, and ECM remodeling. The isolation of ADSC-exos involves methods such as ultracentrifugation, ultrafiltration, and size-exclusion chromatography, with recent advancements in commercial kits and microfluidic technologies improving their purification and application. The bioactive cargos of ADSC-exos include proteins, lipids, and nucleic acids that influence cellular functions, such as angiogenesis, inflammation, and tissue repair. Factors affecting exosome production include culturing conditions, priming with cytokines, and exposure to stress conditions. In clinical applications, ADSC-exos have been used in wound healing, where they promote angiogenesis, reduce inflammation, and enhance tissue repair. They also show promise in musculoskeletal regeneration, promoting chondrogenesis, osteogenesis, and nerve regeneration. In dermatology and plastic surgery, ADSC-exos improve skin elasticity, reduce keloid formation, and enhance fat graft survival. In tissue engineering, ADSC-exos are combined with scaffolds to support tissue regeneration, with examples including alginate hydrogels, collagen-based scaffolds, and 3D-printed scaffolds that enhance bone and cartilage regeneration. These exosomes offer a promising approach for regenerative medicine, with potential applications in treating conditions such as diabetes, obesity, and tissue defects. Their ability to modulate immune responses and promote tissue repair makes them a valuable tool in clinical settings.Adipose-derived stem cell (ADSC) exosomes have shown significant potential in tissue regeneration due to their ability to carry bioactive molecules that regulate inflammation, enhance cell proliferation, and induce angiogenesis. These exosomes, derived from ADSCs, can promote wound healing, musculoskeletal regeneration, dermatology, and plastic surgery, as well as tissue engineering. ADSCs are abundant and easily isolated from adipose tissue, offering a less invasive and more accessible source compared to bone marrow-derived stem cells. They possess multipotency, enabling differentiation into various cell types, and their regenerative properties are mediated by growth factors and cytokines. ADSC-exos can act as cell-free therapies, enhancing tissue repair and regeneration with minimal adverse effects. ADSC-exos are characterized by their ability to modulate immune responses, reduce inflammation, and promote angiogenesis. Their functional properties include the regulation of cell proliferation, differentiation, and ECM remodeling. The isolation of ADSC-exos involves methods such as ultracentrifugation, ultrafiltration, and size-exclusion chromatography, with recent advancements in commercial kits and microfluidic technologies improving their purification and application. The bioactive cargos of ADSC-exos include proteins, lipids, and nucleic acids that influence cellular functions, such as angiogenesis, inflammation, and tissue repair. Factors affecting exosome production include culturing conditions, priming with cytokines, and exposure to stress conditions. In clinical applications, ADSC-exos have been used in wound healing, where they promote angiogenesis, reduce inflammation, and enhance tissue repair. They also show promise in musculoskeletal regeneration, promoting chondrogenesis, osteogenesis, and nerve regeneration. In dermatology and plastic surgery, ADSC-exos improve skin elasticity, reduce keloid formation, and enhance fat graft survival. In tissue engineering, ADSC-exos are combined with scaffolds to support tissue regeneration, with examples including alginate hydrogels, collagen-based scaffolds, and 3D-printed scaffolds that enhance bone and cartilage regeneration. These exosomes offer a promising approach for regenerative medicine, with potential applications in treating conditions such as diabetes, obesity, and tissue defects. Their ability to modulate immune responses and promote tissue repair makes them a valuable tool in clinical settings.