The insulin deficient cluster in the Asian Indian population was similar to SIDD in the Scandinavian population, as was the mild age-related subgroup to MARD (although with a lower age); however, the severely insulin resistant group in our population was also characterized by poor beta-cell function and higher levels of obesity (unlike severe insulin resistant diabetes in the Scandinavian population), while the mild obesity-related diabetes cluster could not be clearly defined in our population. Here, INS is linked to obesity due to melanocortin 4 receptor deficiency.