The nasal septum plays an important role in the growth and support of the human nose, and defects can cause nasal deformities. Extracellular vesicles (EVs) have shown great potential in tissue repair, especially cartilage repair, and stem cell EVs are widely used in the repair of articular cartilage defects but have not been reported in the repair of nasal septal cartilage defects. At the same time, due to the low yield of EVs, which are easy to lose during in-situ injection, better preparation methods are needed to obtain EVs and more suitable carriers for the sustained release of EVs in wounds. Firstly, swelling and degradation experiments were conducted on the scaffold, as well as mechanical performance testing, including observation of the scaffold morphology under SEM. Subsequently, in vitro cell experiments were conducted to evaluate the ability of 3D EVs to promote chondrocyte proliferation, migration, and extracellular matrix formation. Finally, Gel-PLGA loaded with EVs was implanted into the nasal septum defect site of rabbits in vivo animal experiments to observe the repair effect on the defect. In vitro experiments showed that the biological scaffold exhibited good biocompatibility and could effectively promote the proliferation and migration of chondrocytes. In vivo, a composite biological scaffold loaded with EVs was implanted into the nasal septum defect of rabbits, and the tissues were tested at 6 and 12 weeks after surgery. The results indicate that composite scaffolds loaded with EVs can effectively promote the repair of defect sites. The results showed that 3D EVs could promote tissue repair and healing, which provided a new idea for the clinical treatment of nasal septal defects.