Adipose tissue fibrosis is caused by improper remodeling of the extracellular matrix, which leads to abnormal deposition in adipose tissue. As the hallmark of adipose tissue dysfunction, adipose tissue fibrosis has a close relationship with metabolic dysfunction such as obesity and insulin resistance. Therefore, reversing adipose tissue fibrosis can restore the function of adipose tissue, enhance the sensibility of insulin and then improve patients' metabolic abnormalities such as obesity. This review summarizes the latest research progress in the pathological mechanism of adipose tissue fibrosis and the potential drug targets for reversing adipose tissue fibrosis, in order to provide a greater insight into this pathological process and provide the direction of drug development.