Pathway analysis based on screening data showed that the differentially expressed exosomal RNAs were associated with PI3K-Akt signaling pathway, JAK-STAT signaling pathway, TGF-beta signaling pathway, insulin resistance, glycerolipid metabolism, fatty acid degradation, and mTOR signaling pathway, which are important in GDM development and fetus growth. This evidence concerns the gene AKT1 and gestational diabetes.