Objective To explore the effects of an exercise intervention based on the ADOPT model on physical fitness, exercise self-efficacy and exercise adherence in maintenance hemodialysis patients. Methods Patients who met the inclusion and exclusion criteria were randomly divided into a control group and an intervention group according to their dialysis time, with 45 cases in each group.The control group was given conventional dialysis care, while the intervention group additionally received an exercise intervention based on the ADOPT model.The physical fitness indexes （upper limb muscle strength, lower limb muscle strength, dynamic balance, flexibility and aerobic endurance）, exercise self-efficacy and exercise adherence scores were compared between the two groups before and after the intervention. Results Forty-four patients in each of the two groups completed the study, and there were statistically significant differences in physical fitness indexes (except flexibility) and the scores of exercise self-efficacy and exercise compliance between the two groups after 12 weeks of the intervention （all P＜0.05）. Conclusion The exercise intervention based on the ADOPT model can help maintenance hemodialysis patients establish exercise behavior and effectively improve their physical fitness index, exercise self-efficacy and exercise adherence.