Accurate simulations of the flow around lifting hydrofoils are challenging, since they need to capture the flow near the foil surface precisely, represent the free surface, and take into account body motion and deformation. Therefore, these simulations are often computationally expensive. This paper studies numerical methods to limit the costs of hydrofoil simulation. Mesh adaptation is used to efficiently capture the free-surface flow, to resolve flow details around the foil surface, and to ensure the accuracy of mesh motion techniques, like overset meshing. For maximum precision of the boundary-layer flow, adaptation is started from dedicated body-aligned meshes. Hydrofoil flexibility is taken into account through a linear eigenmode-based reduced-order model of the structural response. This approach removes the need to couple directly the fluid and structure solvers and reduces the computational overhead for fluid-structure simulation. Equilibrium positions for flexible and rigid motion are determined with a fixed-point iteration based on approximate models for the forces, which eliminate the need for costly time-accurate simulation. Test cases demonstrate that these methods work together, providing accurate simulation of realistic hydrofoils with reasonable computational costs.