Vector-borne diseases (VBDs) represent a major global public health threat, with climate change emerging as a key driver of their expanding geographic range and increased incidence. This study aims to systematically analyze the global vulnerability of populations to climate-sensitive VBDs, quantify the impacts of climate change on the transmission dynamics of major VBDs (malaria, dengue, Zika, and Lyme disease), and evaluate region-specific adaptive strategies. A mixed-methods approach was employed, integrating global climate data (1990–2024), VBD incidence records from 120 countries, socioeconomic vulnerability indices, and semi-structured interviews with 150 public health stakeholders across 6 continents. The findings reveal significant global variations in vulnerability, with low- and middle-income countries (LMICs) in tropical and subtropical regions (e.g., sub-Saharan Africa, Southeast Asia, Latin America) exhibiting the highest vulnerability due to a combination of climatic suitability for vectors, weak healthcare infrastructure, and socioeconomic deprivation. Climate change-induced increases in temperature, precipitation, and humidity have extended the seasonal activity of vectors (e.g., Anopheles mosquitoes for malaria, Aedes mosquitoes for dengue) by 2–3 months in temperate regions and expanded their geographic range by 15–25% in high-latitude areas over the past three decades. The incidence of dengue has increased by 78% in Southeast Asia and 65% in Latin America since 2000, with climate change contributing an estimated 30–40% of this increase. Region-specific adaptive strategies, such as vector control programs, early warning systems (EWSs), and climate-resilient healthcare infrastructure, have shown varying degrees of effectiveness. For example, community-based vector control in Senegal reduced malaria incidence by 42%, while EWS implementation in Thailand decreased dengue-related hospitalizations by 35%. However, these strategies face significant barriers in LMICs, including limited funding, inadequate technical capacity, and weak intersectoral collaboration. This study highlights the urgent need for globally coordinated, context-appropriate adaptive strategies that integrate climate data into public health planning, strengthen healthcare systems in vulnerable regions, and address the socioeconomic determinants of VBD vulnerability. Such efforts are critical to mitigating the growing burden of climate-sensitive VBDs and advancing global health equity.