Immunometabolic Crosstalk in Adipose Tissue Remodeling: Mechanisms and Therapeutic Perspectives.

Adipose tissue is a dynamic immunometabolic organ whose cellular heterogeneity and functional plasticity are central to systemic energy balance and metabolic regulation. Disruption of immune-adipocyte interactions is closely linked to the development of obesity and related metabolic disorders. In this review, we summarize current advances in understanding of the immune landscape in adipose tissue, with an emphasis on the distinct roles of immune cell subsets. Recent approaches including global and single-cell transcriptomic analysis, spatial profiling, and lineage tracing have expanded our ability to characterize these populations. We further highlight mechanisms through which immune cells influence adipocyte turnover, lipid handling, and thermogenesis, as well as reciprocal signals from adipocytes such as cytokines, lipid mediators, extracellular vesicles, and nutrient exchange. This bidirectional crosstalk governs adipose tissue remodeling and determines the occurrence of metabolic homeostasis or dysfunction. Finally, we provide perspectives into the ways in which these interactions may guide the identification of novel therapeutic targets for obesity and metabolic disease.