In the progression of asymptomatic obesity to a T2DM status, the increased influx of immune cells, especially macrophages, into visceral adipose tissue is mediated by adipocyte-derived chemokines, and this influx is accompanied by inflammatory cytokines such as tumor necrosis factor α (TNFα) and interleukin 6 (IL6) [59,60]. Here, TNF is linked to obesity due to melanocortin 4 receptor deficiency.