Consequently, higher prolactin levels were significantly associated with an elevated risk of development of overweight/obesity (OR 2.59; 95% CI: 1.34–4.97, p = 0.004), insulin resistance (OR 3.33; 95% CI: 1.54–7.19, p = 0.002) and prediabetes (OR 1.98; 95% CI: 1.02–3.85, p = 0.043) in women with PCOS. Here, PRL is linked to obesity due to melanocortin 4 receptor deficiency.