INS and obesity due to melanocortin 4 receptor deficiency: The key aims acknowledge the sub-classification of obesity. They include achieving redistribution of body fat, curtailing excessive androgen levels, and improving insulin resistance. Escobar-Morreale et al. also proposed surgery as an option and noted improved outcomes across reproductive parameters, androgen levels, insulin sensitivity, and resolution of ovulatory dysfunction in patients (BMI > 35) post-surgery [49].