The world is witnessing an alarming increase of gestational diabetes mellitus (GDM), correlated with the current obesity epidemic. GDM now complicates 15–20% of all pregnancies, compromising not only the health of women but ultimately that of the next generation. The programming of metabolic functions in fetuses subjected to the adverse intrauterine environment in GDM pregnancy may have intergenerational effects, and thus perpetuate a vicious cycle which has become a major public health concern. Changes in placental function may contribute to the adverse effects of offspring of women with GDM. Studies by my team, and others, have shown that adipose tissue derived factors including soluble (e.g. adipokines) and membrane-bound vesicles (called exosomes) can impact placental function by inducing inflammation and altering nutrient uptake/transport. For example, we have shown that the secretion of the pro-inflammatory cytokine IL1B is higher from adipose tissue from GDM compared to normal glucose tolerant (NGT) pregnancies. In placenta, IL1B induces inflammation and oxidative stress, and increases amino acid transport and fatty acid accumulation. Furthermore, we have shown that the number of adipose tissue derived exosomes (AT-exo) is significantly higher in GDM and positively correlated with birthweight. Excitingly, AT-exo from women with GDM increases the expression of genes associated with glycolysis and gluconeogenesis in placental cells. In concert with these studies, we have shown that in primary human placental cells, AT-exo from women with GDM significantly increased glucose uptake compared to NGT women. The effect of AT-exo on placental inflammation and oxidative stress is currently in progress. Studies are now also underway to determine the effect of adipose tissue exosomes on placenta metabolism in vivo. In conclusion, our studies demonstrate that maternal adipose tissue secretes factors that are involved in regulating placental function in GDM which may be to be responsible for some of the adverse consequences in this pregnancy complication, such as fetal overgrowth. Future studies are require to determine if regulating the secretion of adipose tissue derived mediators may be a novel therapeutic stratergy to improve outcomes in GDM.