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. Here, AKT1 is linked to Insulin resistance.