INS and obesity due to melanocortin 4 receptor deficiency: However, during obesity, increased lipid reserves in insulin target tissues, such as muscle and liver, are generated, leading to insulin resistance.47 This, as a result of adipocyte hypertrophy and alteration of its adipokine secretory profile, among which TNF-α and macrophage infiltration in adipose tissue produce these and other major interleukins (Interleukin-6 IL-6), for the development of inflammation and metabolic failure.