Adipose-derived stem cells have the effect of promoting tissue repair and regeneration, and its mechanism of action is inseparable from its paracrine role. Exosomes are extracellular vesicle secreted by cells and are a new mechanism for communication between cells. In recent studies, it has been found that stem cell-derived exosomes are a major means of paracrine activity of stem cells and mediate their role in promoting tissue regeneration. The application of exosomes provides a new strategy for tissue repair. In this paper, the application of exosomes derived from adipose-derived stem cells in tissue regeneration was reviewed.