Exosomes derived from ADSCs protect β-cells function by carrying miR-138-5p and regulating the sex-determining region Y (SRY)-box transcription factor 4 (SOX4)-mediated Wnt/β-catenin pathway (63), exosomes derived from M1 macrophages inhibit β-cell insulin secretion by targeting sirtuin 2 (SIRT2) with miR-212-5p and inhibiting the Akt/GSK-3β/β-catenin pathway (64) and Pancreatic cancer-derived exosomes inhibit β-cell function and reduce insulin secretion by targeting adenylate cyclase 1 (ADCY1) and exchange protein directly activated by cAMP 2 (EPAC2) (65). Here, RAPGEF4 is linked to pancreatic neoplasm.