Adipocytes secrete EVs (AdEVs) with cargoes that vary based on the pathophysiological state of the AT at the source of the EVs, which enter the bloodstream and mediate signaling in distant organs. AdEVs are key players in the adipose-liver axis, affecting hepatic metabolism and insulin sensitivity, while also regulating glucose homeostasis in skeletal muscle. Additionally, AdEVs facilitate communication between ATs and the pancreas, influencing insulin secretion and beta-cell function. Moreover, AdEVs contribute to the development of cardiovascular diseases and have central roles in regulating food intake regulation and cognitive functions. The bioactive cargo and effects of AdEVs from lean and obese ATs are depicted in green and red, respectively. Although not shown in the figure, ATM-derived EVs also play an active role in ATorgan metabolic communication. This inter-organ dialogue is bidirectional, as target organs can also release EVs in response to metabolic stress, further influencing systemic metabolic responses. miR, microRNAs; lnc RNAs, long noncoding RNAs; MI/R, myocardial ischemia-reperfusion.
