Question about adenoids? do they have to come out with tonsils?

No, but: It all depends on the patient. Removal of adenoids can help with the airway, decrease the frequency of infections of the ear and sinus, reduce post nasal drip, help with eustachian tube dysfunction, and even improve your voice resonance. The risk of removal is very low. So most surgeons will recommend removal of the adenoids at the same time of tonsils if they are large or chronically infected.