The accompanying music video was directed by Diana Kunst and Mau Morgó, and was released in April 2019 as part of a live MTV special. It features several scenes of Madonna and Maluma interacting, ending with a Latin-inspired feast taking place. The music video received acclaim from critics, who noted resemblances to Madonna's past work. The song was performed live by the singers at the 2019 "Billboard" Music Awards, with the performance featuring several digital effects that were provided by augmented reality, including four virtual versions of Madonna's Madame X alter-ego. "Medellín" was later performed during Madonna's Madame X Tour (2019−2020) and Maluma's (2019−2021).