Background: Health literacy (HL) the ability to access, understand, evaluate, and apply health information, is a critical determinant of cardiovascular disease (CVD) outcomes. Effective management of CVD requires adherence to complex therapies, lifestyle changes, and active self care. Limited HL impairs these processes, leading to poor adherence, worse clinical outcomes, and reduced quality of life. Nurses are uniquely positioned to address HL gaps through patient education and sustained clinical engagement. Objective: To map evidence on HL in adults with CVD, including prevalence, determinants, outcomes, and nursing contributions to HL promotion and patient empowerment. Methods: A scoping review was conducted following the PRISMA-ScR guidelines. PubMed, Scopus, CINAHL, and Web of Science were systematically searched for studies published within the last ten years examining health literacy (HL) among adults with cardiovascular disease (CVD). Data on HL prevalence, measurement tools, associated factors, interventions, and nursing roles were extracted and synthesized using a thematic analysis approach. Results: Low HL affected 30–40% of patients and was associated with older age, lower education, limited income, comorbidities, and system level factors. Low HL correlated with poor adherence, reduced self care, difficulty recognizing warning signs, and higher hospitalization and mortality risks (patients with low HL had a 1.6-fold higher risk of hospitalization and a 1.4–1.6-fold higher risk of mortality). Nurse led interventions using simplified materials, teach back methods, motivational interviewing, and structured follow up improved HL, adherence, self management, and clinical outcomes. Nurses also contributed to creating health literate environments and supporting digital HL. Conclusions: HL is prevalent and modifiable in CVD. Nurses are pivotal in assessing HL, delivering tailored education, supporting behavior change, and empowering patients. Integrating HL into nursing education, clinical practice, and digital health strategies is essential to improve adherence, self management, and cardiovascular outcomes while promoting equitable, patient centered care.