A quantitative proteomics approach revealed that adipose tissue-derived EVs from GDM (Additional file T6) altered pathways related to IL-6, JAK-STAT3 signaling, TGF-β signaling, and ROS (Fig. 4A and B), while EVs from NGT altered TNF-α signaling via NF-kB (Additional file T7). This evidence concerns the gene TNF and gestational diabetes.