INS and Hyperglycemia: In terms of glucose metabolism, hyperglycemia affects bone metabolism balance through multiple mechanisms: on one hand, high glucose levels directly inhibit osteoblast differentiation and function while promoting osteoclast formation and activity (Sheu et al., 2024); on the other hand, the accumulation of advanced glycation end products, insulin resistance, and abnormalities in the insulin-like growth factor-1signaling pathway also contribute to glucose metabolism-related bone disorders (Liu et al., 2023; Mohan and Baylink, 1996).