We observed that maternal age at delivery ≥35 years (29.2% VS 17.1%, P = 0.011), overweight (37.5% VS 20.5%, P < 0.001) and obesity (12.5% VS 3.8%, P < 0.001) were significantly more prevalent in the women treated with insulin, compared to those managed through diet-and-exercise alone (Table 1C). Here, INS is linked to obesity due to melanocortin 4 receptor deficiency.