Physical activity (PA) interventions, now integrated into the care pathway, have gained scientific and institutional legitimacy in the management of chronic diseases. The number of sociological studies on this integration remains limited. This article offers a comprehensive overview, distinguishing three levels of analysis: institutions, organizations, and professions, which are examined within interconnected ecological frameworks. Healthcare organizations and medical disciplines, particularly cardiology and diabetology, have played a significant role in the emergence of PA interventions for patients with chronic conditions. Diabetology has fostered the emergence of a new professional group within the medical field (adapted physical activity instructors), whose work is integrated with therapeutic education. Policymakers have drawn on dynamics emerging from the field to establish adapted physical activity as a new focus of public policy.