Vaccine adjuvants are crucial for reinforcing the immunogenicity of vaccines. Therefore, they are widely used in the aquaculture sector as vaccine components facilitating the efficient prevention of infectious diseases and promoting sustainable teleost fish growth. Despite their benefits, there has been a growing concern about the potential adverse effects of vaccine adjuvants in teleost fish, connoting a valid impact on their overall health and welfare. Among adjuvants used in aquaculture vaccinology, nanoparticle-based formulations have given rise to a promising new alternative to traditional options, such as oil-based emulsions and aluminum compounds, offering the benefit of minimizing relevant side-effects. The aim of this paper was to review the current status of the adjuvants used in aquaculture, provide a description and an evaluation of their mode of action and side-effects, and explore the potential use of nanoparticle formulations as adjuvants to improve the efficacy of aquaculture vaccines. By demonstrating and assessing the equilibrium between teleost fish welfare and immunological efficacy, this review presents a collective perspective that will assist in establishing a framework for the utilization of effective, species-specific practices around adjuvant use in aquaculture, while also addressing the challenges of welfare-friendly immunization.