The repair of peripheral nerve injury has always been a difficult clinical problem. Although a variety of treatment methods are available in clinical practice, their efficacy is limited. In recent years, the components carried by adipose stem cell exosomes and their functions have been increasingly discovered. A large number of experiments conducted around the world have shown that adipose-derived stem cell exosomes have a positive effect on the repair of peripheral nerve injury. This article reviews recent progress toward the use of adipose-derived stem cell exosomes in the repair of injured peripheral nerves and possible future research directions involving adipose-derived stem cell exosomes.