Exosomes from adipose-derived stem cells accelerate wound healing by increasing the release of IL-33 from macrophages

• ADSC-Exos accelerate wound healing by promoting M2 macrophage polarization, reducing inflammation, and enhancing collagen deposition and angiogenesis. • IL-33 is identified as a key mediator in ADSC-Exos-induced wound healing, with its release from macrophages driving keratinocyte proliferation and epithelialization. • The Wnt/β-catenin signaling pathway is activated by IL-33, linking ADSC-Exos to enhanced keratinocyte function. • ADSC-Exos offer a promising cell-free therapeutic strategy for skin repair, potentially overcoming limitations of direct MSC transplantation.