ICAM1 and obesity due to melanocortin 4 receptor deficiency: Women diagnosed with PCOS frequently exhibit obesity and insulin resistance, which are pathophysiological conditions characterized by the transformation of macrophages from an anti-inflammatory M2 phenotype to a pro-inflammatory M1 phenotype, accompanied by increased secretion of interleukin-6 and intercellular adhesion molecule-1 (ICAM-1) (194, 221, 222).