Adipose Tissue Engineering Biomaterials: Smart Scaffolds, Vascularization, and Clinical Frontiers.

Adipose tissue engineering (ATE) is an interdisciplinary field integrating materials science, cell biology, and engineering, aiming to construct functional artificial adipose tissue for addressing adipose tissue deficiency, metabolic disorders, and related clinical challenges. This review systematically summarizes the core advances, critical limitations, and translational potential of ATE. First, we elaborate on the three fundamental elements of ATE: scaffold materials (hydrogels, porous materials, microspheres, fibrous materials, decellularized extracellular matrix, 3D-printed/bioprinted scaffolds, and prevascularized constructs), seed cells (adipose-derived stem cells, mesenchymal stem cells, etc.), and growth factors (vascular endothelial growth factor, fibroblast growth factor, etc.), as well as their synergistic regulatory roles in adipose tissue regeneration. We then discuss the key factors influencing adipogenic differentiation and vascularization, which are pivotal for the formation of functional ATE constructs. Furthermore, we detail the construction and evaluation of in vitro and in vivo ATE models, highlighting the value of large animal models in bridging preclinical and clinical gaps. The applications of ATE in soft tissue repair and reconstruction, drug screening and disease modeling, and cultured meat manufacturing are comprehensively analyzed, with emphasis on technical challenge across different directions. Finally, we discuss the core challenges hindering ATE clinical translation, including lack of standardization of adipose-derived stem cells, immunogenicity issues, regulatory barriers, and technical limitations, and propose targeted future perspectives. This review provides a comprehensive and critical overview of ATE, offering guidance for promoting its translation from preclinical research to clinical practice and industrial application.