INS and obesity due to melanocortin 4 receptor deficiency: Recently, a Finnish population-based cohort study consisting of 649,043 participants born between 2004 and 2014 showed that ASD risk in offspring was three- to six-fold increased for mothers with insulin-treated PGDM and obesity (HR = 3.64; 95% CI = 1.63–8.16), as well as for mothers with insulin-treated PGDM combined with severe obesity (HR = 6.49; 95% CI = 3.08–13.69) compared to normal-weight nondiabetic mothers [12].