The SHAP analysis revealed that features such as obesity, adult weight gain, less exercise, impaired glucose tolerance, hypertriglyceridemia, hypertension, TG/HDL-C ratio, and snoring, were strongly associated with an increased risk of low insulin sensitivity, which is consistent with the findings of previous studies analyzed using traditional statistical methods (18, 20, 47–49). Here, INS is linked to obesity due to melanocortin 4 receptor deficiency.