LEP and obesity due to melanocortin 4 receptor deficiency: At the cellular level, adipocytes contribute to an immunosuppressive tumor microenvironment through the secretion of adipokines (leptin), pro‐inflammatory cytokines (IL‐6, TNF‐α), and extracellular vesicles (Ad‐EVs), while simultaneously inducing metabolic quiescence in tumor cells via downregulation of oxidative phosphorylation and other key metabolic pathways.[266] Systemically, obesity interacts with insulin resistance and lipid metabolism dysregulation, though conventional metrics like BMI poorly reflect this underlying metabolic complexity.