ADIPOQ and obesity due to melanocortin 4 receptor deficiency: Thus, adipose tissue dysfunction in obesity in humans is characterized by adipocyte hypertrophy associated with enhanced extracellular matrix (ECM), focal adhesion and fibrosis, increased macrophage infiltration, and increased release of pro-inflammatory adipokines, while markers of mitochondrial oxidative phosphorylation and secretion of adiponectin are reduced [9,10,11,12].