[Objective] The adaptive siting and layout characteristics of rural settlements in the aquatic environment and the ecological wisdom they contain from the perspective of water-related place names were analyzed to provide theoretical references and inspiration for safety and resilience planning and sustainable development of contemporary rural settlements in the context of climate change. [Methods] Settlement types were classified according to water-related names. Combining textual and spatial analyses, spatial autocorrelation, kernel density estimation, and the SCS-CN hydrological model were comprehensively applied to analyze the adaptive siting and layout characteristics of rural settlements in South Henan Province. [Results] ① The naming of rural settlements in South Henan presents significant aquatic environment orientation, and there is a certain corroborative relationship between place names and spatial patterns. ② The spatial distribution of various types of water-related settlements is significantly clustered and spatially heterogeneous, with a high degree of dependence on the unique water environment. ③ In the macro-level of adaptive siting to the water environment, rural settlements in South Henan have a strong preference for near-water siting and consideration of rain and flood risk. ④ Under the comprehensive influence of the aquatic environment, the adaptive layout features such as site utilization with storage and drainage, village layout to avoid rain and flood, and environmental transformation with consideration of defense have been formed. [Conclusion] The naming of the rural settlements in the Southern Henan region has strong water-related features, and the siting and layout fully embodies the ecological wisdom of water environment adaptation, which tends to benefit from and avoid harm, as well as low technology and ecology. In the future, the concept of water environment adaptation planning can be inherited by watersheds, town and village systems, and facilities.