SGLT2 inhibitors, such as dapagliflozin and empagliflozin, have recently shown promise in reducing heart failure events across a spectrum of ejection fractions (EMPEROR-Preserved, DELIVER), yet their impact on symptom burden, exercise capacity, and quality of life in obesity- or T2D-related HFpEF remains limited [11,12]. This evidence concerns the gene SLC5A2 and obesity due to melanocortin 4 receptor deficiency.