INS and obesity due to melanocortin 4 receptor deficiency: This is attributable to multiple factors, such as hyperglycemia-induced free radicals and free-radical-associated mutagenesis, inhibition of apoptosis, altered insulin signaling, effects of overweight or obesity, poor diet, and lack of physical activity (9, 10), leading to higher risk of breast, endometrial, and colorectal cancers (9, 11, 12).