Adaptive capacity has been described as instrumental for the development of resilience in healthcare. Yet, our theoretical understanding of adaptive capacity remains relatively underdeveloped. This research therefore aims at developing a new understanding of the nature of adaptive capacity by exploring the following research questions: 1. What constitutes adaptive capacity across different healthcare contexts? and 2. What type of enabling factors support adaptive capacity across different healthcare contexts? The study used a novel combination of qualitative methods featuring a metasynthesis of narratives based on empirical research to contribute understanding of adaptive capacity across different healthcare contexts. The findings show that adaptive capacity was found to include four forms: reframing, aligning, coping, and innovating. A framework illustrating the relatedness between the identified forms, in terms of resources, change and enablers, is provided. Based on these findings, a new definition of adaptive capacity for resilience in healthcare is proposed. •Adaptive capacity across healthcare settings include the following forms: coping, aligning, reframing, and innovating.•Enabling factors for adaptive capacity include: knowledge, communication, trust, and the organization of resources.•A new definition of adaptive capacity for resilience in healthcare across healthcare settings is provided.•A new conceptual framework illustrating forms of adaptive capacity in terms of change, resources, and enablers is provided.