INS and obesity due to melanocortin 4 receptor deficiency: Changes in its secretion profile may contribute to insulin and leptin resistance and induce the development of obesity and T2D [23,24], whereas it has been observed that the adipose tissue of lean individuals predominantly secretes anti-inflammatory adipokines such as transforming growth factor-beta (TGF β), adiponectin, apelin, IL-4, IL-10, and IL-13 [25].