INS and obesity due to melanocortin 4 receptor deficiency: Maternal insulin-treated pregestational diabetes (HR, 2.71; 95% CI, 2.03-3.61), type 2 diabetes (HR, 1.97; 95% CI, 1.64-2.37), and gestational diabetes (HR, 1.61; 95% CI, 1.50-1.72) implied an estimated 128%, 54%, and 18% increased risk for offspring to receive any ICD-10 F code diagnosis among mothers with severe obesity compared with mothers with severe obesity only (HR, 1.43; 95% CI, 1.33-1.54), with the reference being normal-weight mothers without diabetes (Figure 1A and Table 2).