AP1B1 encodes the β1/β'-adaptin subunit of the heterotetrameric AP-1 clathrin adaptor complex that drives intracellular receptor transport via clathrin-coated vesicles (PMID:8812422). As a structural subunit, AP1B1 is required for AP-1 complex stability and normal vesicular trafficking in epithelial cells: loss-of-function in patient keratinocytes destabilizes the complex (sharply reducing the γ subunit), produces an excess of abnormal vesicles, and deranges intercellular junction proteins, with wild-type AP1B1 transduction rescuing the vesicular phenotype (PMID:31630788). Through AP-1-mediated sorting of transmembrane cargo, AP1B1 directs the correct trafficking of the copper-transporting ATPases ATP7A and ATP7B; loss-of-function mutations mistraffic these cargoes both at baseline and under copper stimulation, producing abnormal copper homeostasis with low serum copper and ceruloplasmin (PMID:31630791, PMID:40101690). In zebrafish hair cells, ap1b1 mediates basolateral targeting of the Na+/K+-ATPase, and its loss mislocalizes the pump to apical hair bundles with consequent loss of ion homeostasis and impaired mechanotransduction (PMID:23593334). Homozygous loss-of-function mutations in AP1B1 cause a human disorder of copper metabolism with epithelial and ATP7A/B trafficking defects resembling MEDNIK syndrome (PMID:31630791, PMID:31630788).