Adaptive Radiotherapy (ART) is a fundamental shift from static dosimetry to a dynamic, customized procedure that is determined by the patient’s daily biological and anatomical changes. Organs at risk (OARs) may become more toxic, or therapy efficacy may be compromised if these inter-fractional discrepancies are not addressed. AI-driven solutions are the most important part of making things useful. They make it possible how to adapt (Triggered OART) and cut down on the main problem, manual demarcation. To get around the problems with CBCT for proton treatment, employ Robust Planning or Deep Learning-based Synthetic CT (sCT). Dosimetric efficacy is consistently shown; high-level clinical evidence connecting these benefits to enhanced patient outcomes is still developing. Future research must concentrate on large-scale Randomized Controlled Trials (RCTs) and the inclusion of biological and functional MRI biomarkers.