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In the context of accelerated digital transformation, organizations increasingly operate as complex systems in which strategic decision-making is challenged by uncertainty, data heterogeneity, and bounded rationality. The integration of artificial intelligence (AI) into organizational processes is therefore redefining how decisions are supported and enacted. This study develops and validates an integrated conceptual model that explains how trust in AI-based decision support systems (AI-DSSs), data transparency and quality, perceived usefulness, and ease of use influence decision-making efficiency and the intention to adopt AI-DSS in complex organizational contexts. The empirical analysis is based on a questionnaire survey administered to 324 respondents from Romanian organizations operating in IT, services, industry, and public administration. Data were analyzed using partial least squares structural equation modeling (PLS-SEM) implemented in SmartPLS 4. The results show that data transparency and quality strongly enhance trust in AI-DSS (β = 0.784, p < 0.001). Trust positively influences both perceived usefulness (β = 0.229, p < 0.01) and perceived ease of use (β = 0.482, p < 0.001), confirming its role as a key psychological enabler of favorable technology perceptions. Furthermore, perceived ease of use significantly affects perceived usefulness (β = 0.597, p < 0.001). Regarding adoption-related attitudes, perceived usefulness (β = 0.352, p < 0.001), trust (β = 0.311, p < 0.001), and perceived ease of use (β = 0.135, p < 0.05) exert significant positive effects on the intention to adopt AI-DSS, which in turn demonstrates a strong association with decision-making efficiency (β = 0.544, p < 0.001). By extending traditional technology acceptance models (TAM) with AI-specific dimensions—namely transparency, data quality, and trust—this study contributes to the literature on decision-making in complex systems and offers practical insights for organizations seeking to improve decision effectiveness through AI-based support.