Future quantum communication infrastructures will rely on both terrestrial and space-based links integrating high-performance optical systems engineered for this purpose. In space-based downlinks in particular, the loss budget and the variations in the signal propagation due to atmospheric turbulence effects impose a careful optimization of the coupling of light in single-mode fibers required for interfacing with the receiving stations and the ground networks. In this work, we perform a comprehensive study of the role of adaptive optics (AO) in this optimization, focusing on realistic baseline configurations of prepare-and-measure quantum key distribution (QKD), with both discrete and continuous-variable encoding, and including finite-size effects. Our analysis uses existing experimental turbulence datasets at both day and night time to model the coupled signal statistics following a wavefront distortion correction with AO, and allows us to estimate the secret key rate for a range of critical parameters, such as turbulence strength, satellite altitude and ground telescope diameter. The results we derive illustrate the interest of adopting advanced AO techniques in several practical configurations.