INS and obesity due to melanocortin 4 receptor deficiency: It is important to note that previous studies have shown that exercise interventions do not always lead to statistically significant improvements in HOMA-IR and HDL, LDL, triglycerides, total cholesterol concentrations and insulin resistance in children and adolescents with obesity [57,58]; however, when aerobic exercise is implemented, it is more likely to improve fasting insulin levels, insulin resistance, as well as, blood lipid levels [46,59].