Macrophages, a heterogeneous population of innate immune cells, exhibit remarkable plasticity and play pivotal roles in coordinating immune responses and maintaining tissue homeostasis within the context of metabolic diseases. The activation of inflammatory macrophages in obese adipose tissue leads to detrimental effects, inducing insulin resistance through increased inflammation, impaired thermogenesis, and adipose tissue fibrosis. Meanwhile, adipose tissue macrophages also play a beneficial role in maintaining adipose tissue homeostasis by regulating angiogenesis, facilitating the clearance of dead adipocytes, and promoting mitochondrial transfer. Exploring the heterogeneity of macrophages in obese adipose tissue is crucial for unraveling the pathogenesis of obesity and holds significant potential for targeted therapeutic interventions. Recently, the dual effects and some potential regulatory mechanisms of macrophages in adipose tissue have been elucidated using single-cell technology. In this review, we present a comprehensive overview of the intricate activation mechanisms and diverse functions of macrophages in adipose tissue during obesity, as well as explore the potential of drug delivery systems targeting macrophages, aiming to enhance the understanding of current regulatory mechanisms that may be potentially targeted for treating obesity or metabolic diseases.

巨噬细胞是先天免疫细胞的异质群体，表现出显着的可塑性，在代谢疾病背景下协调免疫反应和维持组织稳态方面发挥着关键作用。肥胖脂肪组织中炎症巨噬细胞的激活会导致有害影响，通过炎症增加、产热受损和脂肪组织纤维化诱导胰岛素抵抗。同时，脂肪组织巨噬细胞还通过调节血管生成、促进死亡脂肪细胞的清除和促进线粒体转移，在维持脂肪组织稳态方面发挥有益作用。探索肥胖脂肪组织中巨噬细胞的异质性对于阐明肥胖的发病机制至关重要，并且对于靶向治疗干预具有巨大的潜力。最近，利用单细胞技术阐明了脂肪组织中巨噬细胞的双重作用和一些潜在的调节机制。在这篇综述中，我们全面概述了肥胖期间脂肪组织中巨噬细胞的复杂激活机制和多样化功能，并探索了针对巨噬细胞的药物递送系统的潜力，旨在增强对当前可能的调节机制的理解。潜在的目标是治疗肥胖或代谢疾病。