[9] During his career in business, he served on various wildlife and hunting committees, as well as the board of directors of the Fellowship of Christian Athletes organization.

Ainsworth was unopposed in the Republican primary and faced Democratic nominee and former representative Jeff McLaughlin in the November general election.

[8][10] When describing his reasons for his candidacy, Ainsworth said that he hoped to fight back against "career politicians", positioning himself as an outsider, and to prevent regulation of small businesses.

[15] He also criticized Roy Moore's suspension from the Alabama Supreme Court over legal disputes regarding same-sex marriage, saying that the Southern Poverty Law Center was attacking "godly men" and forcing "immoral and dangerous beliefs onto society".

[17] Ainsworth supported the Alabama Memorial Preservation Act of 2017, signed by Governor Kay Ivey that prohibits local authorities from removing monuments or renaming public schools that have existed for over 40 years.

[19][20] He also sponsored ethics-focused legislation to enact term limits and remove office holders who abuse their position.

[25] During the Republican primary for lieutenant governor, Ainsworth received the endorsement of Senator Marco Rubio, whose state campaign he had previously chaired.

[27] In the June 2018 primary, Ainsworth finished in second place behind Twinkle Cavanaugh, the president of the Alabama Public Service Commission.

In an interview with the Alabama Political Reporter, Ainsworth presented a letter from the Jackson County Sheriff's Office that stated he had never been convicted of such a crime and only held a minor boating infraction with the department.

He admitted that he had been arrested for what he called a "college prank" in which fiberglass tigers were stolen, but no charges were ever filed against Ainsworth and the statues were returned.

When an exemption for rape and incest was struck from the bill, Democratic state senators accused Ainsworth of gaveling the removal too quickly.

[32] Ainsworth has also promoted a ban on critical race theory[33] and supported school choice,[34] as well as constitutional carry.

Following reports that Brookside had engaged in aggressive ticketing as a speed trap, Ainsworth requested a state audit of the town and its police department.