Question: At the end Jigsaw says Adam isn't ungrateful to be alive anymore, but why does he lock Adam in the bathroom and say "game over" instead of helping him?
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Answer: He does help him technically. He tells him the key to the lock is in the bathtub (we saw it disappear down the plughole when Adam woke up at the beginning). In Jigsaw's sick, twisted mind he feels he is giving Adam a chance to prove he wants to live by getting the key. To prove he is grateful, he needs to find out how to get the key back. Which is technically impossible for Adam to do, leaving only one fate for him to remain.
The_Iceman
Getting the key back has nothing to do with how grateful he is or isn't, as the key wasn't meant to go down the drain.