Research is exploring the role of microRNA shuttled in small extracellular vesicles, including those derived from mesenchymal stem/stromal cells, in treating various diseases. These vesicles have been studied in the context of osteoarticular disease, as well as other conditions such as neuroinflammation, cardiac remodeling, and multiple sclerosis. The potential of extracellular vesicles and their microRNA cargo as therapeutic tools and diagnostic biomarkers is being investigated across several disease areas.