In recent years, exosomes have been used as a medium for cell-cell communication, providing a new perspective for information exchange between cells. Exosomes from various cell types, such as mesenchymal stem cells, osteoblasts, osteoclasts, and their precursors, are play an important role in bone remodeling. Many studies have shown that common bone metabolic diseases, such as osteoporosis, fracture, and osteoarthritis, have obvious correlations with exocrine bodies. Although bisphosphonate drug treatment, autologous and allograft bone grafting, and other treatment method achieve good result , they may lead to various complications and adverse reactions. Therefore, it is very meaningful to develop new targeted therapies with a strong bone regeneration ability, lower complication rate, and more accuracy. Therefore, this article reviews the mechanism of exosomes from various sources acting on bone tissue cells and the application of related bone metabolism disease treatments to provide ideas for developing new bone regeneration treatment method.