The most common cause of syndrome NDM is autosomal recessive mutations in eukaryotic translation initiation factor 2-α kinase 3 (EIF2Ak3) (diabetes associated with renal dysfunction/epiphyseal dysplasia), Solute carrier family 2 member 2 (SLC2A2) (diabetes associated with facilitated glucose transporter), Solute carrier family 19, member 2 (SLC19A2) (diabetes associated with megaloblastic anemia syndrome), Insulin receptor (INSR) (diabetes associated with severe IR), and Forkhead box P3 (FOXP3) (diabetes associated with polyendocrinopathy/immunodysregulation) [29,30,31,34,35]. The gene discussed is INSR; the disease is Down syndrome.