Floating vertical axis wind turbines are bearing complex aerodynamic fatigue loads due to the movement of the platform and the reciprocating variations in the angle of attack and the blade relative wind speed. To explore the effect of the surge motion of the platform and verify the performance and acting mechanism of adaptive pitch control on reducing the fatigue loads and improving the power coefficient, a floating vertical axis wind turbine with three motion forms (non-surge, pure surge, and surge-adaptive pitch) is investigated in the condition of a low tip speed ratio with a high incoming wind speed. The results show that the surge motion enhances the fatigue loads, with the power coefficient less affected. The adaptive pitch control reduces the enhanced fatigue loads and improves the power coefficient by nearly twice. Vorticity and pressure distributions verify that the fluctuation ranges of the angle of attack and the blade relative wind speed are expanded by the surge motion, and the angle of attack is reduced by the adaptive pitch control especially in the upwind section, with the flow separation mitigated. However, the effects of the surge motion and the pitch variation are also influenced by the shedding vortex and the flow separation reattachment. For the upwind part of the blade aerodynamic forces, with the surge amplitude increase or the surge period decrease, the global amplitudes are increased gradually by the surge motion and then reduced by the pitch control, with the load reduction performance enhanced gradually.