Some myokines affected by obesity and exercise include IL-6 which plays an anti-inflammatory role alongside improving insulin-stimulated glucose uptake and glucose transporter GLUT 4 translocation in skeletal muscle (333, 334), metrnl which has been linked to worsening glucose tolerance and plays a role in thermogenic and energy expenditure pathways (335, 336) and irisin which is associated with insulin resistance and has been implicated in the browning of white fat among its musculoskeletal roles (337-339). Here, INS is linked to obesity due to melanocortin 4 receptor deficiency.