Gorbacheva combined teaching philosophy with sociological research during the years she lived in Stavropol. She lectured for the Znanie adult-education society and at the city's medical and agricultural institutes. Her fieldwork among collective-farm families examined rural life and changing social conditions, forming the basis of the dissertation for which she received an advanced degree in 1967. After moving to Moscow in 1978, she taught at Moscow State University.

When Mikhail Gorbachev became Soviet leader in 1985, she took an unusually visible public role for a Soviet leader's wife. She accompanied him on foreign visits, met cultural figures and political spouses, and spoke with journalists and members of the public. Her appearance and participation attracted interest abroad and criticism at home. In 1986 she helped establish the Soviet Cultural Foundation, supporting the preservation of historic buildings, collections, and Russian cultural material held overseas.

She also promoted medical care for children, especially those with leukemia, working with charitable organizations and helping raise support for treatment. During the attempted coup of August 1991, she was confined with her husband at their residence in Foros, Crimea. After the Soviet Union dissolved, she continued cultural and charitable work through the Gorbachev Foundation and associated projects. Her own diagnosis of leukemia took her to treatment in Münster, Germany, where she died in September 1999.