Adiponectin (AD) is an adipocyte-specific secretory protein that is highly expressed in adipose tissue. AD levels are decreased in patients with cardiovascular diseases and type 2 diabetes (DM). This study aimed to analyze the relationship between low levels of adiponectin, diabetes and myocardial infarction. A systematic review was conducted following the PRISMA guidelines. Papers were selected searching PubMed/Medline database in July 2021 using the terms [adiponectin] AND [diabetes] AND [myocardial infarction]. The inclusion criteria were limited to observational studies that evaluated the association between adiponectin index in myocardial infarction among diabetic patients. There were no language or publication date restrictions.Among the 130 papers initially identified, 49 were eligible for this review. AD, inhibits liver gluconeogenesis, displays anti-atherogenic and anti-inflammatory properties and promotes peripheral insulin sensitivity. Lower levels of AD are related to a higher risk of myocardial infarction and a worse prognosis in patients with coronary artery disease. Favorable effects of AD are associated with maintained ischemia-induced angiogenesis, decreased myocyte death, decreased hypertrophic response, reduced interstitial fibrosis and attenuated inflammatory response. It has been suggested that high molecular weight AD is more important for vascular protection. Nevertheless, it is unknown if higher levels of AD are associated with a reduced risk for coronary heart disease and myocardial infarction among diabetic individuals.Although the adiponectin´s pattern of cardioprotection is well stablished, it is still unclear if higher levels are associated with reduced risk of coronary heart disease and myocardial infarction among diabetic individuals.