This paper suggests that while institutions and institutional change (which the authors characterise as the ‘means’) are often mentioned in policy discourses on climate change adaptation (characterised as the ‘end’), the details of policy processes are less often discussed. The authors specify concepts and themes around institutional theory that could be applicable to climate change adaptation, and discuss issues related to climate change adaptation with the varying degrees of uncertainty related to climate impacts. It is noted that while policy discussions have included sectorial portfolios (such as water, spatial planning, health, and emergency management), central agencies related to finance, taxation, law and industry are rarely mentioned. The paper also suggests that climate change research and policy have only recently connected with the idea of sustainable development. Therefore, a useful approach would be to think of climate adaptation policy as coordination and reform of other policy sectors. The paper also sets an agenda for the knowledge community to delve into “unfamiliar and perhaps boring territory” related to institutions.