INS and hyperinsulinism: Paulukinas, Mesaros, and Penning confirmed the connection between hyperinsulinemia and hyperandrogenism in 2022, when they discovered that the aldo-keto reductase family 1 member C3 (AKR1C3), an insulin driven enzyme, plays a key role in androgen production in adipocytes driven by insulin and identified AKR1C3 as a potential therapeutic target to reduce androgen excess [24].