INS and obesity due to melanocortin 4 receptor deficiency: Increased DNL and excessive TG accumulation in the liver caused by metabolic alterations are hallmarks of NAFLD pathology and are strongly associated with obesity, insulin resistance, and type 2 diabetes.[28, 29, 30] To identify whether SIX1 is responsive to the insulin signal, we analyzed the expression of SIX1 in hepatocytes.