Message exchange patterns (MEPs) define the order and direction of message exchanges between distributed systems. The basic MEPs are request/response, where a consumer sends a request and waits for a response, and one-way, where a message is sent without an expected response. More complex patterns include request/callback for asynchronous responses, publish/subscribe for one-way notifications, and approaches for handling errors. MEPs can vary between layers, and event-driven architectures use events as asynchronous messages to decouple systems into process chains.