INS and metabolic syndrome: Considering the growing prevalence of minimally invasive bariatric procedures, future prospective and structured studies (with an assessment of the hypothalamic-pituitary-ovarian axis) focusing on insulin/obesity-related infertility, especially in patients affected by PCOS, will certainly be needed based on the excellent results on the effects of ESG on metabolic syndrome and diabetes shown by Abu Dayyeh et al. [13].