While achieving desired performance, there exist still many challenges in current cellular networks to support the multimedia content dissemination services. The conventional multimedia transmission schemes tend to serve all multicast group members with the data rate supported by the receiving user with the worst channel condition. The recent work discusses how to provide satisfactory quality of service (QoS) for all receiving users with different quality of experience (QoE) requirements, but the energy efficiency improvement of multimedia content dissemination is not its focus. In this paper, we address it based on adaptive clustering and device-to-device (D2D) multicast and propose an energy-efficient multimedia content dissemination scheme under a consistent QoE constraint. Our scheme extends the recent work with the proposed K-means-based D2D clustering method and the proposed game-based incentive mechanism, which can improve energy efficiency of multimedia content dissemination on the premise of ensuring the desired QoE for most multicast group members. In the proposed scheme, we jointly consider the cellular multicast, intracluster D2D multicast, and intercluster D2D multicast for designing the energy-efficient multimedia content dissemination scheme. In particular, we formulate the energy-efficient multicast transmission problem as a Stackelberg game model, where the macro base station (MBS) is the leader and the candidate D2D cluster heads (DCHs) are the followers. Also, the MBS acts as the buyer who buys the power from the candidate DCHs for intracluster and intercluster D2D multicast communications, and the candidate DCHs act as the sellers who earn reward by helping the MBS with D2D multicast communications. Through analyzing the above game model, we derive the Stackelberg equilibrium as the optimal allocation for cellular multicast power, intracluster D2D multicast power, and intercluster D2D multicast power, which can maximize the MBS’s utility function. Finally, the proposed scheme is verified through the simulation experiments designed in this paper.