When simulating fluids, tetrahedral methods provide flexibility and ease of adaptivity that Cartesian grids find difficult to match. However, this approach has so far been limited by two conflicting requirements. First, accurate simulation requires quality Delaunay meshes and the use of circumcentric pressures. Second, meshes must align with potentially complex moving surfaces and boundaries, necessitating continuous remeshing. Unfortunately, sacrificing mesh quality in favour of speed yields inaccurate velocities and simulation artifacts. We describe how to eliminate the boundary-matching constraint by adapting recent embedded boundary techniques to tetrahedra, so that neither air nor solid boundaries need to align with mesh geometry. This enables the use of high quality, arbitrarily graded, non-conforming Delaunay meshes, which are simpler and faster to generate. Temporal coherence can also be exploited by reusing meshes over adjacent timesteps to further reduce meshing costs. Lastly, our free surface boundary condition eliminates the spurious currents that previous methods exhibited for slow or static scenarios. We provide several examples demonstrating that our efficient tetrahedral embedded boundary method can substantially increase the flexibility and accuracy of adaptive Eulerian fluid simulation.