One recently released guideline (Obesity, diabetes mellitus, and cardiometabolic risk: An Obesity Medicine Association (OMA) Clinical Practice Statement (CPS) 2023) (73) highlighted associations of treatment with exogenous insulin with weight gain and excess risk of cardiovascular outcomes (23, 24, 33, 74–76), similar to risks associated with sulfonylurea use. This evidence concerns the gene INS and obesity due to melanocortin 4 receptor deficiency.