Adipokines are cellular signaling proteins produced by adipose tissue and are nowadays the focus of extensive research. They play roles in a variety of processes including inflammation, modulation of energy and appetite, lipid and glucose metabolism, insulin sensitivity, endothelial cell function, angiogenesis, blood pressure regulation, and hemostasis. An increase in white adipose tissue in obesity, namely its visceral depot, affects the production and secretion of adipokines and are associated with metabolic and cardiovascular diseases due to reduced sensitivity to insulin, low angiogenic potential, and increased lipolytic activity. Adiponectin may influence ovarian physiology by affecting genes essential for ovarian follicular development and ovarian reserve, including kisspeptin and AMH. Adiponectin dysregulation may be one of the possible mechanism responsible for reduced insulin sensitivity in PCOS. This review attempted to highlight the inflammatory aspect of obesity and metabolic disorder and the role of adiponectin in the pathophysiology of ovary under metabolic dysregulation.