The article discusses modern views on the metabolic characteristics of adipose tissue in patients with non-alcoholic fatty liver disease (NAFLD). An association has been shown between NAFLD and metabolic risk factors such as dyslipidemia, hyperglycemia, and visceral obesity. The analysis of modern literature on adipose tissue as an endocrine organ is carried out. The recently revealed physiological and pathophysiological properties of adipokines are discussed. It has been documented that adiponectin counteracts the effect of angiotensin II on endothelial cells and prevents their apoptosis by increasing the association between eNOS and heat shock protein. Adiponectin can function as a negative regulator of angiogenesis. It inhibits the proliferation and migration of endothelial cells and markedly inhibits the growth of new blood vessels. The ratio of adiponectin to leptin is a biomarker of adipose tissue dysfunction and correlates better and more accurately with insulin resistance than adiponectin or leptin. The researchers concluded that fatty tissue dysfunction caused by low adiponectin levels may contribute to oxidative stress and inflammation. Medications aimed at synthesizing adiponectin will be useful in the treatment of NAFLD, obesity, diabetes, and cardiovascular disease.