Evapotranspiration (ET) is the most significant constituent of the response to climate warming. It serves as a crucial link in the soil–vegetation–atmospheric continuum. Analyzing the driving forces and response of ET to regional-scale climate warming holds scientific significance in improving global water resource assessment methods and drought monitoring techniques. The innovation presented in this article is the calculation of ET by using GRACE/GRACE-FO satellite data through the water balance equation. The inter-annual and seasonal changes in ET in different regions of the Qilian Mountains were analyzed, along with quantifying the contribution of environmental meteorological factors to ET. The ETGRACE and ETMonitor products have good consistency, with a monthly correlation coefficient of 0.92, an NSE coefficient of 0.80, and a root mean square error of 10.38 mm. The results indicate that the increasing trend of ET in the Qilian Mountains region exhibits a “medium–high–low” distribution pattern. The rate of increase in ET is 5.2 mm/year in the central segment. In spring and summer, the overall trend of ET is an increasing one. However, the central and western segments exhibit a slight decreasing trend of ET in autumn. During winter, the southern part of the Qilian Mountains experiences a notable reduction in ET. The correlation between the changes in ET and soil moisture exhibited a strong association, with soil moisture change contributing significantly to ET: 57.8% for the eastern section, 52.8% for the middle section, and 46.9% for the western section. The thermal effect primarily controls ET variations within eastern sections, where temperature change accounts for approximately 6.7% of the total variation in ET levels. Conversely, the moisture factor dominates western sections, where precipitation change accounts for about 6.5% of the total variation in ET levels. Due to the distinct gradient characteristics of environmental meteorological factors in the central segment, the fluctuation of these factors collaboratively drives ET changes. This article provides a new approach for obtaining continuous and reliable actual evapotranspiration in high-altitude areas.