INS and obesity due to melanocortin 4 receptor deficiency: In this article, we specifically focus on the metabolic abnormalities related to EVs and diabetes, including obesity, inflammation, insulin resistance, β-cell damage, etc. We aim to explore how extracellular vesicles participate in the occurrence and development of diabetic complications, comprehensively examining the interactions between extracellular vesicles and key aspects of diabetes, forming a comprehensive and profound research framework.