Liquid microlenses and their arrays (LMLAs) have emerged as a transformative platform in adaptive optics, offering superior reconfigurability, compactness, and fast response compared to conventional solid-state lenses. This review summarizes recent progress from an application-oriented perspective, focusing on actuation mechanisms, fabrication strategies, and functional performance. Among actuation mechanisms, electric-field-driven approaches are highlighted, including electrowetting for shape tuning and liquid crystal-based refractive-index tuning techniques. The former excels in tuning range and response speed, whereas the latter enables programmable wavefront control with lower optical aberrations but limited efficiency. Notably, double-emulsion configurations, with fast interfacial actuation and inherent structural stability, demonstrate great potential for highly integrated optical components. Fabrication methodologies—including semiconductor-derived processes, additive manufacturing, and dynamic molding—are evaluated, revealing trade-offs among scalability, structural complexity, and cost. Functionally, advances in focal length tuning, field-of-view expansion, depth-of-field extension, and aberration correction have been achieved, though strong coupling among these parameters still constrains system-level performance. Looking forward, innovations in functional materials, hybrid fabrication, and computational imaging are expected to mitigate these constraints. These developments will accelerate applications in microscopy, endoscopy, AR/VR displays, industrial inspection, and machine vision, while paving the way for intelligent photonic systems that integrate adaptive optics with machine learning for real-time control.