The inclusion of students with Autism Spectrum Disorder (ASD) in Brazilian Higher Education constitutes a critical challenge, reflecting tensions between normative advances and structural barriers that perpetuate inequalities, especially in regional contexts such as the Midwest. This topic gains relevance in light of the growing demand for educational equity and the underrepresentation of autistic populations in public universities. The main objective of this study was to analyze inclusive policies and practices for students with ASD at the Federal Universities of UnB, UFG, UFMT, and UFMS, focusing on the Institutional Development Plans (IDPs) from 2018 to 2023, a study derived from the author’s doctoral thesis. A qualitative documentary approach was adopted, grounded in historical-dialectical materialism, analyzing IDPs, legal frameworks, and data from the 2023 Higher Education Census, focusing on the four institutions selected for their regional representativeness. The results highlight progress in architectural and pedagogical accessibility, led by initiatives such as UnB’s PAPNE and UFMS’s SEAAF, which improve retention, contrasting with gaps at UFMT, marked by the absence of specific actions and higher dropout rates. The underrepresentation of ASD students and the intersectional effects of race and gender emerge as structural barriers. The conclusion indicates that substantive inclusion requires continuous teacher training, personalized protocols, and institutional transparency, offering a theoretical framework that challenges educational commodification and guides transformative policies. This study enriches the field of Inclusive Education, proposing actionable strategies and opening pathways to address autistic adult populations in academic contexts.