INS and obesity due to melanocortin 4 receptor deficiency: For example, obesity causes IL-6 to have a compensatory role, increasing islet glucagon-like peptide-1 (GLP-1) production, which augments insulin secretion in order to adapt to IR and prevent T2DM.14 In addition, obesity can alter adipokine production, which regulates body weight, appetite and energy expenditure and modulates IR.