Ecosystem restoration can yield multiple benefits, and the quantitative accounting of ecosystem service value (ESV) profits and losses is of significant importance to the economic benefits of ecosystem restoration. This study reveals the dynamic impacts of climate change on ESVs by analyzing the effects of climate variables on ESV profits and losses across different periods and scenarios. The research findings are as follows: (1) From 1990 to 2020, and extending to simulated projections for 2030, China’s ESV exhibits a high distribution pattern in the southern regions. In 2030, under the natural development scenario (NDS), the southwestern region shows a coexistence of high and low ESVs. Under the ecological protection scenario (EPS), ESV in the southwestern region increases, whereas under the urban development scenario (UDS), ESV in the southwest decreases. (2) In both the NDS and UDS, the trends in ESV profits and losses continue from 2010 to 2020. Under the EPS, there is a significant increase in ESV in the southwestern region. The largest contributors to ESV loss are the conversion of grassland to unused land and forest to farmland. The southwestern region shows the most significant spatial differences in ESV profits and losses, with an increase in ESV profits in the northeastern region. In contrast, other regions show no significant spatial differences in ESV profits and losses. (3) From 1990 to 2000, Bio13 (the precipitation of the wettest month) and Bio12 (annual precipitation) had a significant positive impact on ESV profits and losses, indicating that increased precipitation promotes the functioning of ESVs. This study indicates that fluctuations in precipitation and temperature are significant climate factors influencing the value of ESV. Due to climate change, precipitation patterns and temperature swings are now key determinants of ESV changes. By carefully studying ESV profits and losses and their driving factors, this research can serve as the scientific basis for ecosystem restoration and management strategies.