TNF and obesity due to melanocortin 4 receptor deficiency: Pro-inflammatory cytokines such as tumor necrosis-alpha (TNF-α), interleukin-1 (IL-1), and interleukin-6 (IL-6), which are increased in response to obesity, induce insulin resistance at a molecular level by modulating the insulin signaling pathway [19,20,21,22,23,24,25,26,27].