• FOXO1 is identified as a key m6A-modified gene during ADSC osteogenesis, with FTO demethylase enhancing RUNX2 and suppressing PPARG to promote differentiation.
• FTO knockdown impairs ADSC migration, proliferation, and osteogenesis, highlighting its critical role in bone regeneration.
• Mechanistically, FTO translocates to the cytoplasm and directly binds FOXO1 mRNA at the 1760th bp site, revealing a novel regulatory axis.
• NSAIDs containing FTO inhibitors impede ADSC-mediated bone formation, suggesting potential drug interactions in clinical bone repair.