Annotation. Visfatin is now recognized as an integral representative of adipokines – bioregulators, predominately released by adipose tissue, that play a decisive role in paracrine and systemic regulation of different organs and systems activity. Visfatin exhibits a wide range of functions as a pro-inflammatory, immunomodulatory cytokine, hormone-like substance with insulin-mimetic properties. The dysregulation of visfatin synthesis has been implicated in obesity, metabolic syndrome, type 2 diabetes, however, the role of visfatin in cardiovascular dysfunction pathogenesis under the above mentioned conditions still remains in the dark. This review aims to provide a comprehensive overview of visfatin’s role in the metabolism regulation under physiological conditions and in obesity, its impact on small signaling molecules production in cardiovascular system, unwind possible correlations with cardiovascular dysfunction, formulate potential trends and prospects of dysadipokinemia management. An information search was conducted in specialized scientific databases Scopus, Web of Science, PubMed, MEDLINE, Google Scholar with a depth of 5 years (2018-2023). Queries were made using the standardized keywords of the MeSH (Medical Subject Headings) database: visfatin (Nampt), obesity, hydrogen sulfide, homocysteine, cardiomyopathy. Publications containing the results of randomized controlled trials, meta-analyses, and original studies on the problem outlined above were selected for in-depth analysis. We assume that modulators of H2S exchange are able to correct the production of visfatin in obesity and thus prevent the development of complications from the cardiovascular system, but this issue requires further study.