High-speed trains inevitably experience the impact of complex temperature loads during operation, which can easily result in cracks. Structural health monitoring methods based on Lamb waves are affected by the impact of temperature on their propagation mechanism, leading to difficulties in constructing accurate damage diagnostic models. This paper proposes a crack damage identification method based on adaptive multi-scale sample entropy under variable temperature environment. A sliding window method is proposed to obtain multiple wave packets in a Lamb wave, which avoids the disadvantage of insufficient information of a single wave packet and improves the robustness and reliability of diagnosis. A variance-based multiscale transform method is proposed to process Lamb wave signals, which reduces the sensitivity of Lamb wave signals to temperature compared to the traditional mean-based multiscale transform method. Lamb waves in different sliding windows are transformed at multiple scales to extract damage Multi-scale sample entropy (MSE) at different scales. The Quantum genetic algorithm (QGA) is introduced to optimize sliding windows and MSE, achieving adaptive MSE extraction under variable temperature environments. Based on the advantage of adaptive multiscale entropy, a quantitative crack diagnosis model is established. To verify the effectiveness of the proposed method, crack detection experiments under variable temperatures were conducted. The results show that the proposed adaptive MSE has good resistance to temperature changes and can accurately identify crack length.