Descriptive theories tell us how to understand the world better and prescriptive theories tell us how to make the world better. Design theories are of the latter kind but usually involves a product or process artifact to create changes as well. Despite a focus on utility, there is little evidence about how design theories become adopted after their development. We know too little about how design theories are applied, adopted, adapted, and emerge and change over time. We present a study of an organizational change design theory that was adopted in 108 different organizations. The results indicate that the theory was adopted As-Is in 25% of the cases. But it was adapted in various ways for use in the remaining organizations. Our analysis of these cases provides a typology of eight categories of adoptability. Among these, organizations most commonly adapted the recommended organizational strategy. As a result of these and other findings we show how design theory adoption is a continuous co-creation process between design theorists and design adopters.