The Aggies have now dropped five straight games for the first time since 1993.
Adams was 8 of 10 from the floor and had only one turnover in 32 minutes but was ejected for a flagrant 2 technical foul with 5:37 left.
Riley Grabau had 15 points while Larry Nance Jr. added 13 and Derek Cooke Jr. had 11 points and eight rebounds for the Cowboys (14-7, 5-3 Mountain West).
Utah State (12-9, 2-7) was paced by Spencer Butterfield with 12 points while Preston Medlin had 11. The Aggies never led but were able to tie the game three times in the first raight,half.
The Cowboys were up 65-47 when Adams and Butterfield got into an altercation on the right perimeter. It appeared that Adams punched Butterfield in the mid-section and Butterfield retaliated by shoving Adams onto a table that separates the first row of fans from the floor. Butterfield was assessed a personal foul and Adams a flagrant 2 technical, resulting in his exit from the arena.
Wyoming assistant coach Jeremy Shyatt, who filled in for his ailing father, head coach Larry Shyatt, was uncertain if Adams will be available for the Cowboys' game at New Mexico on Wednesday.
"That decision's out of our hands," the younger Shyatt said. "I think it's something the league office needs to takes a look at. I'm sure they've been through this before and they'll give a fair assessment."
Larry Shyatt stayed home on doctor's advice because of a viral infection. It was the second game he has missed this season because of the ailment.
Wyoming scored on 11 of 13 possessions bridging halftime and outscored Utah State 24-12 during the 7 1/2 minute stretch to take control. Adams was 4 of 5 from the floor with 11 points during the surge, which left Wyoming ahead 49-35.
"We needed to attack them offensively, but we had to be smart and not force the issue," Jeremy Shyatt said. "We played very smart and we made the extra pass. And what can you say about 15 assists and 5 turnovers? I thought they really showed their poise and especially down the stretch."
Adams' final assist came as he was driving the lane. He tripped, but just before he hit the floor he was able to flip a no-look pass to Cooke for a layup. Cooke was fouled and hit the free throw to give Wyoming its widest lead at 65-44 with 6:25 remaining.
Adams wasn't available for postgame comments, but Grabau gave his teammate credit for the victory.
"He won us the game just by his setting the tone on offensive and defensively," Grabau said. "He took care of the ball. He had just had one turnover. That's a pretty good turnover ratio."
Wyoming outshot Utah State 53 percent to 40 percent and the Cowboys were 8 of 14 from beyond the arc (57 percent). The Aggies, who came in as the top 3-point shooting team in the conference at 41 percent, were 7 of 18 (39 percent).
"They just kinda toyed with us," Utah State coach Stew Morrill said. "They just ran us around and eventually we'd break down and they'd drive in for a dunk or kick for a 3. We're a mess right now. We can't play offense. We can't play defense. We've lost our confidence. We're gonna have to have a full flip to be competitive the second half of the league (race)."
Butterfield was asked if the Aggies, who were picked fifth but are mired near the bottom of the Mountain West standings, are having trouble adjusting to their new league.
"It could be," he said. "I mean, honestly, I think we let a couple ones slip and we're just having a little bit of hangover from that, so we need to just move on and keep moving forward." Josh Adams had 19 points and a career-high eight assists to lead Wyoming to a 74-57 win over Utah State on Saturday.