The reason for the "adverbs are the devil" rule is they are generally "telling", not "showing".
The reason we want to "show" instead of "tell" is that it is the writer's job to assist the imagination of the reader.
To do that, we need to appeal to their senses, primarily visual and auditory, but also senses of heat, humidity, touch, and emotional feelings of the POV characters.
In your case, a "patronizing" attitude would be better expressed by letting the reader realize it is patronizing by whatever the character said, instead of just telling us it is a "patronizing" smile. What is that actually like?
It is like an adult talking to child, it is smug, and that is something you can show us.
Yes, adverbs are a part of speech, but so are tones of voice, so are facial expressions, so is volume and the way we draw out words or clip them or say them with force. The job is to stimulate the imagination with a complete scene.
Using an adverb informs the reader of a fact, but leaves them on their own for imagining how that played out.
The adage of "show don't tell" originates in theater and film, where it can be taken more literally. A character behaves as if they are angry, they don't say "I am angry."
In print, people that argue "it is all telling" are missing the point; in print the distinction is the same as in film: Does the audience imagine a character behaving as if they are angry, or does the author just tell us, "Cindy is angry" ?
Writing that helps the reader imagine a scene and action is better than writing that doesn't. Adverbs are very weak tea in the imagination department, and a shortcut that should seldom be taken, but replacing them with another form of "telling" doesn't help the situation. This is what you have done with your two examples.
Is there any difference in this between him looking smug, or condescending, or as if he is superior? I don't think so. The acts of being patronizing would be more specific and concrete, as would the experience of being patronized, either would be better aid to the imagination than just telling us his smile is patronizing.