INS and type 2 diabetes mellitus: In addition, studies have shown that the activation of the insulin signal transduction pathway (IRS1/PI3K) in skeletal muscle of T2DM patients is reduced, and the activation of its downstream signaling molecules Akt, PKC-zeta and TBCID4 is impaired, thereby damaging insulin-stimulated vesicles (GSVs) translocation, causing IR in skeletal muscle [32,33].