This study explores the role of exosomal miR-483-5p derived from the serum of polycystic ovary syndrome (PCOS) patients on PCOS progression. The expressions of miRNAs in exosomes from patients with or without PCOS (PCOS-exo or HC-exo) were quantified. Serum sex steroids, endocrine indexes, the association of miR-483-5p with PCOS were assessed in the clinical samples. HC-exo or PCOS-exo was injected into PCOS rats, and the location of exosomes was examined, in addition to detection on pathology changes, and autophagic vacuole. VAPB expression was measured as well as the uptake of exosomes by human ovarian granulosa cells, COV434 cells. COV434 cells were incubated or transfected with PCOS-exo, pcDNA3.1-VAPB, miR-483-5p Agomir, or miR-483-5p Antagomir, and then autophagy levels were detected. Interactions between miR-483-5p and VAPB were revealed. High expression of miR-483-5p was found in PCOS-exo, which was positively associated with PCOS-related indicators. PCOS-exo mainly located in follicles. Increased miR-483-5p and autophagosome formation as well as decreased VAPB were found in PCOS-exo. Human ovarian granulosa cells could endocytosed exosomes. PCOS-exo elicited autophagy in COV434 cells, which was reversed by miR-483-5p Antagomir or pcDNA3.1-VAPB. miR-483-5p targeted VAPB. Collectively, PCOS-exo derived miR-483-5p downregulates VAPB in granulosa cells, thus promoting granulosa cell autophagy and affecting PCOS.