Sullivan and collaborators demonstrated that obesity alters skeletal muscle-derived EV miRNAs, affecting mRNA targets belonging to the growth pathways (cardiac hypertrophy, Wnt/β-catenin, Phosphoinositide 3-kinases/RAC-alpha serine/threonine-protein kinase, PI3K/AKT, Insulin-like growth factor 1, IGF-1, and Phosphatase and tensin homolog, PTEN) and inflammation signaling (Pigment endothelium-derived factor, PEDF, death receptor, and Gαi). Here, IGF1 is linked to obesity due to melanocortin 4 receptor deficiency.