Diabetic retinopathy(DR)represents one of the microvascular complications that severely imperil the visual health of patients, the pathogenesis involves inflammation, oxidative stress, and vascular endothelial dysfunction, and other aspects. Adipocytokines are closely linked to the onset and progression of diabetes mellitus. This article elaborates on the pathophysiological mechanisms underlying the role of adipocytokines in DR, with a specific focus on the functions of key adipocytokines such as Leptin, Chemerin, Omentin-1, and Apelin. Simultaneously, it analyzes the potential clinical application value of adipocytokines in the diagnosis, mechanism of action, prognostic assessment, and prediction of DR. A deeper comprehension of the mechanisms by which adipokines act on DR provides new insights for exploring the synergistic regulatory mechanisms of multiple adipokines, as well as for the early diagnosis, targeted therapy, and disease monitoring of DR.