Adipose tissue is a complex, essential, and highly active metabolic and endocrine organ. It is not an inactive organ that serves only to store excess energy, as it has been considered for many years. This review paper first describes the physiology of adipocytes and adipose tissue under normal circumstances. It also describes adipose tissue dysfunction, defines the relationship between adipose tissue dysfunction and obesity, explains how adipose tissue dysfunction can be involved in the onset of type 2 diabetes and atherosclerotic vascular diseases, and documents interventions affecting adipose tissue function.