Metabolic syndrome (METS) and type 2 diabetes (T2D) are major global health problems for which current pharmacological treatment does not halt disease progression.1 Bariatric surgery, in particular Roux-en-Y gastric bypass (RYGB) and vertical sleeve gastrectomy, has been effective in reversing insulin resistance, although the underlying mechanisms are not fully understood. The gene discussed is INS; the disease is type 2 diabetes mellitus.