Adipose-derived stem cells (ADSCs) therapy has emerged as a promising strategy for treating degenerative, inflammatory, and cardiometabolic diseases. In addition to their higher bioavailability in adipose tissue, ADSCs demonstrate superior activity in producing specific immune modulators and growth factors when compared to other stem cell types. The detrimental impact of heart failure (HF)—a condition that still lacks a fully effective therapy—has driven significant interest in the therapeutic potential of ADSCs. This interest is supported by robust evidence from experimental studies employing HF animal models. Accordingly, this review aims to explore the cardioprotective mechanisms through which ADSCs may exert beneficial effects in the context of HF.