In obesity, the hypertrophic adipocytes exhibit impaired secretion of anti-inflammatory adipokines such as adiponectin, but augmented secretion of a large number of pro-inflammatory mediators, such as IL-6, C-C motif chemokine ligand 2 (CCL2), IL-1β and resistin that lead to a chronic inflammatory state linking obesity to its cardiometabolic comorbidities including insulin resistance, T2D and cardiovascular events (40). Here, ADIPOQ is linked to obesity due to melanocortin 4 receptor deficiency.