{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T01:39:51Z","timestamp":1789781991799,"version":"4.0.1"},"reference-count":110,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T00:00:00Z","timestamp":1780012800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:p>Diabetes is a major global public health challenge. Diabetic foot ulcer (DFU), one of its most severe complications, imposes a substantial economic burden and severely impairs patients\u2019 quality of life. Current treatment strategies often yield suboptimal outcomes, underscoring the urgent need for novel therapeutic approaches. Adipose-derived stem cell exosomes (ADSC-Exos) have emerged as a promising cell-free therapy with significant clinical potential. This review integrates the mechanisms through which ADSC-Exos facilitate diabetic wound healing with the phases of wound healing. It elucidates that ADSC-Exos function by alleviating oxidative stress, modulating inflammation, promoting angiogenesis, stimulating cell proliferation and migration, and suppressing excessive fibrosis. Additionally, this study organizes insights into how delivery strategies based on smart materials (e.g., hydrogels and bioscaffolds) and the latest physical modalities can overcome bottlenecks in clinical translation. This review aims to provide an integrated perspective for developing next-generation DFU therapies.<\/jats:p>","DOI":"10.3389\/fendo.2026.1795114","type":"journal-article","created":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T04:49:46Z","timestamp":1780030186000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Adipose-derived stem cell exosomes: from functional mechanisms to clinical translation in diabetic foot ulcer management"],"prefix":"10.3389","volume":"17","author":[{"given":"Xintong","family":"Zhong","sequence":"first","affiliation":[{"name":"The Affiliated Eye Hospital, Jiangxi Medical College, Nanchang University","place":["Nanchang, China"]},{"name":"School of Optometry and Ophthalmology, Jiangxi Medical College, Nanchang University","place":["Nanchang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guohui","family":"Wu","sequence":"additional","affiliation":[{"name":"The Affiliated Eye Hospital, Jiangxi Medical College, Nanchang University","place":["Nanchang, China"]},{"name":"Jiangxi Clinical Research Center for Ophthalmic Disease","place":["Nanchang, China"]},{"name":"Jiangxi Provincial Key Laboratory of Vitreoretinal Diseases for Health","place":["Nanchang, China"]},{"name":"Jiangxi Province Key Laboratory of Ophthalmology and Vision Sciences","place":["Nanchang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,5,29]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2019.107843","article-title":"Global and regional diabetes prevalence estimates for 2019 and projections for 2030 and 2045: Results from the International Diabetes Federation Diabetes Atlas, 9(th) edition","volume":"157","author":"Saeedi","year":"2019","journal-title":"Diabetes Res Clin Pract"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1056\/nejmra1615439","article-title":"Diabetic foot ulcers and their recurrence","volume":"376","author":"Armstrong","year":"2017","journal-title":"N Engl J Med"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.3390\/jcm9061780","article-title":"Prevalence, clinical aspects and outcomes in a large cohort of persons with diabetic foot disease: Comparison between neuropathic and ischemic ulcers","volume":"9","author":"Meloni","year":"2020","journal-title":"J Clin Med"},{"key":"B4","doi-asserted-by":"publisher","first-page":"36","DOI":"10.1111\/dom.14840","article-title":"Global mortality of diabetic foot ulcer: A systematic review and meta-analysis of observational studies","volume":"25","author":"Chen","year":"2023","journal-title":"Diabetes Obes Metab"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.3390\/medicina57101072","article-title":"Diabetic wound-healing science","volume":"57","author":"Burgess","year":"2021","journal-title":"Med Kaunas"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.22.7.1036","article-title":"A prospective study of risk factors for diabetic foot ulcer. 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