INS and obesity due to melanocortin 4 receptor deficiency: This may be related to abnormal insulin metabolism, and insulin resistance is believed to be a bridge between overweight, obesity, and fatty liver, and they are mutually causal.[22,23] The basis of IR is the increased secretion of hormones and cytokines from adipocytes caused by obesity, and related endocrine changes affect the storage and mobilization of fat, thereby altering insulin sensitivity.[24]