Consistent with the association observed for BMI, participants with obesity had lower adipose tissue ACE2 expression compared to normal-weight controls (β [95% CI] = −0.34[−0.50, −0.17]; P = 4.81 × 10−5) (Fig. 1 and Supplementary Table 1). Here, ACE2 is linked to obesity due to melanocortin 4 receptor deficiency.