Bariatric metabolic surgery (MBS) is an important therapeutic option for severe obesity and obesity-related metabolic disorders; however, its long-term effectiveness largely depends on postoperative adherence and the quality of longitudinal, comprehensive care. Postoperative adherence is multidimensional, encompassing follow-up adherence, dietary and medication adherence, and exercise adherence, and is influenced by a range of factors including sociodemographic characteristics, psychological and behavioral problems, family and social support, healthcare accessibility, and the design of follow-up workflows. Case management emphasizes patient-centered continuous assessment, multidisciplinary coordination, and structured follow-up support. The existing literature generally suggests that case management may improve weight maintenance and related clinical outcomes by increasing follow-up participation and strengthening self-monitoring and behavioral support; nevertheless, the evidence is limited by substantial heterogeneity in study designs and intervention components, non-uniform outcome measures, and insufficient basis for causal inference. Based on current evidence and clinical needs, a postoperative care pathway integrating stage-based, standardized, individualized, and digital approaches is recommended to establish a closed-loop system of "assessment-intervention-feedback and correction." Future high-quality prospective studies, grounded in unified core outcome sets and standardized management frameworks, are warranted to identify the active components and cost-effectiveness of case management and to provide robust evidence for its wider implementation.