Although armadillo repeat-containing 5 (ARMC5) gene mutations are primarily associated with primary bilateral macronodular adrenal hyperplasia and Cushing's syndrome, their potential role in other endocrine disorders remains largely unexplored. A 50-year-old man presented with limb weakness and persistent hypokalemia. This evidence concerns the gene ARMC5 and Cushing syndrome due to macronodular adrenal hyperplasia.