TNF and obesity due to melanocortin 4 receptor deficiency: Obesity can lead to insulin resistance and affect insulin secretion and utilization (Amin et al. 2019) As obesity progresses, fatty tissue begins to secrete hormones such as tumor necrosis factor-alpha (TNF-α) and interleukin-6 (IL-6), which exacerbate insulin resistance (Rohm et al. 2022).